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Disseminated tuberculosis in children—a difficult diagnose depends on how far we can go
  1. Siyaram Didel1,
  2. Abhishek Purohit2,
  3. Varuna Vyas1 and
  4. Prawin Kumar1
  1. 1Pediatrics, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India
  2. 2Pathology and Lab Medicine, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Siyaram Didel; drdsram2001{at}


Tuberculosis (TB) is an important public health problem in developing countries. In India, despite substantial efforts targeting TB and its associated risk factors, the number of cases remains high with 2.7 million new cases per year with a minimum 10% case contributed by paediatric TB. Disseminated TB has been increasingly recognised in children in recent times due to the increased prevalence of immune suppression secondary to AIDS and immunosuppressive therapies for various medical disorders and increasing awareness. Here we describe a 5-year-old girl who presented with fever of unknown cause, and her diagnosis of disseminated TB was delayed due to atypical presentation and the paucibacillary nature of paediatric TB. It was a bone marrow examination report which led us to clinch the diagnosis. The case highlights the difficulty in diagnosing disseminated TB and the importance of bone marrow examination in such cases.

  • pathology
  • haematology (incl blood transfusion)
  • TB and other respiratory infections
  • infection (neurology)
  • paediatrics

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  • Contributors SD—writing and editing the manuscript, literature review and case management. AP—bone marrow evaluation and pathological part of literature review, and editing the manuscript. VV—writing and editing the manuscript and case management. PK—writing and editing the manuscript and case management.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.