Revista do Instituto de Medicina Tropical de São Paulo (Oct 2020)

Severe gastrintestinal bleeding as an unusual presentation of pediatric tuberculosis: a situation for injectable antituberculous drugs use?

  • Ana Carolina Etrusco Zaroni Santos,
  • Jaques Sztajnbok,
  • Amaro Nunes Duarte-Neto,
  • Amanda Freire Tamburini Sousa,
  • Alessandra Geisler Daud Lopes,
  • Anna Carlota Mott Barrientos

DOI
https://doi.org/10.1590/s1678-9946202062078
Journal volume & issue
Vol. 62

Abstract

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ABSTRACT Disseminated tuberculosis is a severe disease with high-mortality that requires early diagnosis and treatment. Intestinal tuberculosis accounts for only 2% of tuberculosis cases worldwide and is extremely rare in children. We report a case of a 4-year-old girl admitted due to disseminated tuberculosis with extensive intestinal involvement characterized by massive intestinal bleeding and hemorrhagic shock. The severity of the intestinal involvement precluded the exclusive use of oral anti-tuberculosis drugs and the patient was successfully treated with a combination of injectable and oral anti-tuberculosis agents. We discuss the importance of a regimen with injectable drugs for treating severe forms of tuberculosis in which the intestinal involvement impaired the use of oral drugs.

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