Pulmonary and Ileal Tuberculosis Presenting as Fever of Undetermined Origin

• Main Authors: Gajanan Surewad, Ivona Lobo, Preeti Shanbag
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2014-10-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: gastro-intestinal; tuberculosis; tree-in-bud sign
• Online Access: https://jcdr.net/articles/PDF/4998/9695_CE(Ra)_F(Sh)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf

A 12-year-old girl presented with prolonged fever with no obvious focus on either history or clinical examination. High-resolution computerized tomography of the chest revealed the ‘tree-in-bud’ sign in the right lung and necrotic mediastinal lymph nodes. Barium meal showed multiple ileal strictures. The child was treated with anti-tuberculous therapy for six months. At follow-up six months later, the child had gained weight and had no signs of intestinal obstruction. Tuberculosis is a common cause of fever of undetermined origin and should be investigated for especially in countries with a high prevalence.