Clinical Report: Challenges in Pediatric Tuberculosis in Ethiopia

Overview

This report details a case of a 6-year-old girl with severe pediatric tuberculosis, complicated by deep vein thrombosis and an enterocutaneous fistula. The case underscores the diagnostic challenges and severe manifestations of tuberculosis in children, particularly in high-burden settings like Ethiopia.

Background

Pediatric tuberculosis poses significant diagnostic and treatment challenges, particularly in resource-limited settings. In Ethiopia, the high incidence of tuberculosis, coupled with undernutrition and variable vaccination coverage, contributes to severe disease presentations in children. Understanding these complexities is crucial for improving outcomes in this vulnerable population.

Data Highlights

No numerical data or trial data is presented in the article.

Key Findings

• A 6-year-old girl presented with severe acute malnutrition and bacteriologically confirmed widespread tuberculosis.
• She developed deep vein thrombosis and a spontaneous enterocutaneous fistula, rare complications of tuberculosis.
• Initial treatment was ineffective, leading to significant deterioration over three months.
• Diagnostic challenges in pediatric tuberculosis include nonspecific symptoms and the high prevalence of extrapulmonary manifestations.
• Thromboembolic events are notably more common in hospitalized children with tuberculosis.

Clinical Implications

Healthcare providers should maintain a high index of suspicion for tuberculosis in children presenting with severe malnutrition and nonspecific symptoms. Early diagnosis and management of complications such as deep vein thrombosis are essential to improve outcomes in pediatric tuberculosis cases.

Conclusion

This case highlights the complexities of managing pediatric tuberculosis and the need for heightened awareness and improved diagnostic strategies in high-burden regions.

References

1. World Health Organization, Global Tuberculosis Report 2025 -- WHO Global Tuberculosis Report 2025
2. Open Forum Infectious Diseases, Evaluating the Efficacy of Tongue Swabs for Diagnosing Tuberculosis in Hospitalized Children Aged Under 5 -- Evaluating the Efficacy of Tongue Swabs for Diagnosing Tuberculosis in Hospitalized Children Aged Under 5
3. Infection, Increased Likelihood of Drug-Resistant Tuberculosis Among IGRA-Negative Contacts: Is Preventive Treatment Warranted? -- Increased Likelihood of Drug-Resistant Tuberculosis Among IGRA-Negative Contacts: Is Preventive Treatment Warranted?
4. Infection, Clinical Characteristics, Treatment Efficacy, and Mortality Risk Associated with Tuberculosis Sepsis in Patients Without HIV: A Systematic Review and Meta-Analysis of Case Reports -- Clinical Characteristics, Treatment Efficacy, and Mortality Risk Associated with Tuberculosis Sepsis in Patients Without HIV
5. Open Forum Infectious Diseases — Tuberculosis Originating from a Donor in Three Recipients of Solid Organ Transplants from the Same Source
6. WHO releases updated guidelines on tuberculosis preventive treatment
7. Hypercoagulability in Tuberculosis: Pathophysiological Mechanisms, Associated Risks, and Advances in Management
8. Global Tuberculosis Report 2025