Case Report: Unmasking disseminated tuberculosis: A challenging case of neurological, gastrointestinal manifestations, and deep vein thrombosis in a pediatric patient

Disseminated tuberculosis can affect multiple organ systems, including the CNS and gastrointestinal tract, and can be associated with thrombotic complications such as DVT. Early diagnosis is critical to reducing morbidity and mortality. This case report discusses the presentation, diagnostic challenges, management, and the rare occurrence of DVT in a child with disseminated TB. A 10-year-old male presented with a month-long history of fever, difficulty walking, slurred speech, and projectile vomiting. Neurological exam revealed left-sided hemiparesis and a GCS of 15/15. Imaging showed hypodense lesions with a mass effect, and CSF Gene Xpert and RT PCR confirmed tubercular meningitis. He later developed gastrointestinal symptoms, diagnosed as granulomatous colitis. On day 12, ultrasound revealed a right iliac vein thrombus, confirming DVT. He improved clinically and was discharged on ATT with steroids. This case underscores the importance of recognizing the diverse presentations of disseminated TB, particularly in children with a history of exposure. The diagnostic delay may lead to severe complications, necessitating a high index of suspicion for TB in atypical presentations. The link between DVT and disseminated TB emphasizes the importance of monitoring for thrombotic events. Timely diagnosis and management of disseminated TB can significantly impact patient outcomes. This case highlights the need for awareness among healthcare providers to consider TB in differential diagnoses, especially in children presenting with neurological and gastrointestinal symptoms, as well as the potential for thrombotic complications. • Disseminated TB in a 10-year-old affected both neurological and gastrointestinal systems. • Child presented with TB meningitis, neurological deficits, colitis, and GI bleeding. • Rare DVT complication observed in pediatric TB case, managed with anticoagulants. • Multidisciplinary care using ATT, steroids, and anticoagulation improved outcomes.