Generalized tuberculosis with intestinal lesion in an adolescent. Case report

In the two recent decades a decrease in tuberculosis (TB) incidence has been observed worldwide, according to the World Health Organization, while the incidence of extrapulmonary TB, including TB of the intestine, is growing. Generally, diagnosis of TB in children and adolescents is difficult due to its subclinical course in a significant part of patients. A special diagnostic challenge is extrapulmonary TB, including abdominal TB. Abdominal TB has entered the top five most frequent manifestations of extrapulmonary TB along with TB of the peripheral lymph nodes, urogenital TB, bone and joint TB, and TB of the central nervous system. Lack of specific clinical signs of the disease results in late diagnosis of abdominal TB. We described a case of generalized TB with intestinal lesion in an adolescent. We detected mistakes in the follow-up of the female patient with double exposure to household TB, which resulted in late diagnosis of the disease. We demonstrated the challenges in diagnosing intestinal TB under the guise of appendicitis, which led to the development of complications – spilled peritonitis and abdominal abscess. The tactics of management of the female patient at high risk for developing bowel obstruction was represented. Interdisciplinary interactions with extrapulmonary TB specialists were accented for cases of generalized TB.