A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy

Mengyue Tong,1 Wenrui Ding,1 Hao Wu,1 Lijiao Yuan,1 Xin Ma,1 Xiaotao Yang,1 Yanchun Wang,1 Yonghan Luo1,2 1Second Department of Infectious Disease, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, Yunnan, People’s Republic of China; 2Faculty of Lif...

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Main Authors: Tong M, Ding W, Wu H, Yuan L, Ma X, Yang X, Wang Y, Luo Y
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/a-case-report-of-pediatric-abdominal-tuberculosis-with-intestinal-perf-peer-reviewed-fulltext-article-IDR
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author Tong M
Ding W
Wu H
Yuan L
Ma X
Yang X
Wang Y
Luo Y
author_facet Tong M
Ding W
Wu H
Yuan L
Ma X
Yang X
Wang Y
Luo Y
author_sort Tong M
collection DOAJ
description Mengyue Tong,1 Wenrui Ding,1 Hao Wu,1 Lijiao Yuan,1 Xin Ma,1 Xiaotao Yang,1 Yanchun Wang,1 Yonghan Luo1,2 1Second Department of Infectious Disease, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, Yunnan, People’s Republic of China; 2Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of ChinaCorrespondence: Yonghan Luo; Yanchun Wang, Second Department of Infectious Disease, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, Yunnan, 650000, People’s Republic of China, Email luoyonghan050@163.com; wangyanchun0204@163.comBackground: Abdominal tuberculosis (TB) in pediatric patients is a rare but serious condition that can often be misdiagnosed as malignancy or other abdominal disorders. Intestinal perforation is a rare and life-threatening complication that presents significant diagnostic and therapeutic challenges.Case Report: We report a case of a 13-year-old girl from a TB-endemic region who presented with abdominal distension, weight loss, and vomiting. Initial imaging revealed a multilocular cystic mass in the abdominal cavity, raising suspicion of malignancy. Despite negative results from the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), diagnostic laparoscopy identified severe intestinal adhesions and multiple perforations. Histopathological examination confirmed abdominal TB, and Mycobacterium tuberculosis was detected in peritoneal fluid using Xpert TB-DNA testing. The patient underwent emergency small bowel ostomy and received intravenous antitubercular therapy along with broad-spectrum antibiotics due to concurrent bacterial infection. After clinical improvement, oral anti-TB therapy was initiated, leading to significant resolution of abdominal pathology.Conclusion: This case highlights the diagnostic complexity of pediatric abdominal TB, particularly when presenting with an abdominal mass complicated by intestinal perforation. Misleading clinical and imaging findings, along with negative immunological tests, may delay diagnosis. Clinicians in TB-endemic regions should maintain a high index of suspicion for TB in cases of unexplained abdominal masses, especially when routine tests fail to provide a clear diagnosis.Keywords: abdominal tuberculosis, intestinal perforation, pediatrics, misdiagnosis
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series Infection and Drug Resistance
spelling doaj-art-e00f1d33eab64ef3881bd7bdb708a41b2025-08-20T03:17:53ZengDove Medical PressInfection and Drug Resistance1178-69732025-07-01Volume 18Issue 135053509104730A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as MalignancyTong M0Ding WWu H1Yuan LMa XYang XWang Y2Luo Y3Second Department of Infectious Diseasedepartment of infectious diseaseSecond department of infectious diseaseSecond department of infectious diseaseMengyue Tong,1 Wenrui Ding,1 Hao Wu,1 Lijiao Yuan,1 Xin Ma,1 Xiaotao Yang,1 Yanchun Wang,1 Yonghan Luo1,2 1Second Department of Infectious Disease, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, Yunnan, People’s Republic of China; 2Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of ChinaCorrespondence: Yonghan Luo; Yanchun Wang, Second Department of Infectious Disease, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, Yunnan, 650000, People’s Republic of China, Email luoyonghan050@163.com; wangyanchun0204@163.comBackground: Abdominal tuberculosis (TB) in pediatric patients is a rare but serious condition that can often be misdiagnosed as malignancy or other abdominal disorders. Intestinal perforation is a rare and life-threatening complication that presents significant diagnostic and therapeutic challenges.Case Report: We report a case of a 13-year-old girl from a TB-endemic region who presented with abdominal distension, weight loss, and vomiting. Initial imaging revealed a multilocular cystic mass in the abdominal cavity, raising suspicion of malignancy. Despite negative results from the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), diagnostic laparoscopy identified severe intestinal adhesions and multiple perforations. Histopathological examination confirmed abdominal TB, and Mycobacterium tuberculosis was detected in peritoneal fluid using Xpert TB-DNA testing. The patient underwent emergency small bowel ostomy and received intravenous antitubercular therapy along with broad-spectrum antibiotics due to concurrent bacterial infection. After clinical improvement, oral anti-TB therapy was initiated, leading to significant resolution of abdominal pathology.Conclusion: This case highlights the diagnostic complexity of pediatric abdominal TB, particularly when presenting with an abdominal mass complicated by intestinal perforation. Misleading clinical and imaging findings, along with negative immunological tests, may delay diagnosis. Clinicians in TB-endemic regions should maintain a high index of suspicion for TB in cases of unexplained abdominal masses, especially when routine tests fail to provide a clear diagnosis.Keywords: abdominal tuberculosis, intestinal perforation, pediatrics, misdiagnosishttps://www.dovepress.com/a-case-report-of-pediatric-abdominal-tuberculosis-with-intestinal-perf-peer-reviewed-fulltext-article-IDRAbdominal tuberculosisIntestinal perforationPediatricsMisdiagnosis
spellingShingle Tong M
Ding W
Wu H
Yuan L
Ma X
Yang X
Wang Y
Luo Y
A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
Infection and Drug Resistance
Abdominal tuberculosis
Intestinal perforation
Pediatrics
Misdiagnosis
title A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
title_full A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
title_fullStr A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
title_full_unstemmed A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
title_short A Case Report of Pediatric Abdominal Tuberculosis with Intestinal Perforation Misdiagnosed as Malignancy
title_sort case report of pediatric abdominal tuberculosis with intestinal perforation misdiagnosed as malignancy
topic Abdominal tuberculosis
Intestinal perforation
Pediatrics
Misdiagnosis
url https://www.dovepress.com/a-case-report-of-pediatric-abdominal-tuberculosis-with-intestinal-perf-peer-reviewed-fulltext-article-IDR
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