Recurrent Bilateral Pleural and Pericardial Effusions due to Tuberculosis in a Child With Doose Syndrome: A Case Report

Abstract

Tuberculosis (TB) is one of the 10 causes of death worldwide. According to the World Health Organization (WHO) in the 2020 Global Tuberculosis Report, 12% of all infected people correspond to children. Other reports have been published with collected data regarding extra pulmonary TB showing that it reaches 16% of incident cases in United States of America. Pleural TB is common among adolescents and is less frequent in children. Pericardial effusion due to TB is a rare manifestation of extra pulmonary TB, and the diagnosis can be hard to reach. In this paper, we describe the manifestations, diagnosis and management of children with extra pulmonary disease, specifically the simultaneous presence of two sites of TB and the approach in children with Doose syndrome. A 9-year-old male patient with an extensive medical record was admitted with unspecific lower respiratory infection symptoms. The diagnosis was reached with the GeneXpert test after 1 month of evaluation and readmission for massive pleural effusion. He required tube drainage twice and specific management with rifampicin, isoniazid, pyrazinamide and ethambutol. In this case, the symptoms were nonspecific which delayed the diagnosis. The purpose of this case is to emphasize the importance of suspicion and early diagnosis of extra pulmonary TB known as the “great mimicker”. Int J Clin Pediatr. 2022;11(1):14-19 doi: https://doi.org/10.14740/ijcp456