Tuberculosis in pediatrics: case report

Abstract

Introduction. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, a highly pathogenic, aerobic, non-encapsulated microorganism that is most prevalent in developing countries. Therefore, it is considered of public health importance. Its high pathogenicity and virulence in pediatric patients make it necessary to take prompt action upon diagnostic suspicion with an adequate therapeutic approach. The socioeconomic inequality that this pathology represents cannot be ignored, so health promotion and prevention play a fundamental role in reducing the prevalence of this and many other preventable infectious pathologies. Case report. A clinical case of tuberculosis in pediatrics is presented, attended at the Hospital Universitario del Quindío San Juan de Dios, a female patient of 14 years and 6 months of age, Colombian nationality, without pathological or family history of importance, with adequate family support network. She was admitted to the institution with 2 weeks of evolution of high respiratory symptoms (intermittent dry cough) with subsequent evolution to frank hematemesis, with significant blood loss leading to shock, hemodynamic instability that required hydric support and transfusion of blood products. Upon admission to the emergency department, control paraclinical tests were requested to clarify the cause of these symptoms, which reported the presence of anemia, leukocytosis, metabolic acidosis. A chest X-ray showed the presence of diffuse interstitial infiltrates without consolidation, upper gastrointestinal endoscopy within normal parameters, negative serial smear tests.

Due to the clinical condition of the patient, she was referred to the fourth level of care, where she was discharged with antibiotic treatment for the management of bacterial pneumonia. Shortly after hospital discharge, she was reconsulted for a new episode of hemoptysis with hemorrhagic shock and worsening of the pulmonary pattern, the information of the previous hospitalization and extrainstitutional hospitalization was collected and new laboratories were taken that allowed to focus the case and give the diagnosis of TB. Conclusion. It is evident that this pathology, although it has a classic pattern, in many occasions it can show new symptomatology. Therefore, it is important to know the different paraclinical tools that can help us to focus this diagnosis and manage it in a timely manner.

Keywords. Pulmonary tuberculosis - Hemoptysis - Pediatrics - Pneumonia