Hospital Municipal Infantil Menino Jesus , Unidade de Terapia Intensiva Pediátrica , São Paulo , São Paulo , Brazil.
Instituto de Infectologia Emílio Ribas , São Paulo , São Paulo , Brazil.
Rev Inst Med Trop Sao Paulo. 2020 Oct 30;62:e78. doi: 10.1590/S1678-9946202062078. eCollection 2020.
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.
播散性肺结核是一种严重的高死亡率疾病，需要早期诊断和治疗。肠结核占全球结核病病例的 2%，在儿童中极为罕见。我们报告了一例 4 岁女孩因播散性肺结核入院的病例，广泛的肠道受累表现为大量肠出血和出血性休克。肠道受累的严重程度排除了单独使用口服抗结核药物的可能性，患者成功地接受了注射和口服抗结核药物的联合治疗。我们讨论了对于肠道受累影响口服药物使用的严重结核病形式，使用注射药物方案治疗的重要性。
