Generalized Lymphadenopathy in an 8-Month-Old Infant: Visual Diagnosis.

Abstract

Mycobacterium tuberculosis (TB) cases in the US, although less frequent, have been on the rise recently especially after the COVID-19 pandemic with numbers reaching as high as those last seen in 2013. It is a highly contagious disease and, if left un-checked, can lead to long-term nation-wise public health crisis. Infants and children account for a major chunk of global TB burden. TB can have varied presentation in infants depending upon extent of spread and the organ system involved. Infants are prone to contact mycobacterium TB infections and develop a life-threatening (although rare) disseminated infection because of their immature immune status. It is important to timely diagnose and treat to avoid the transmission and morbidity. Radiological evaluations including X-ray, CT-scan and MRI play a vital role when the symptoms are ill defined. Although not commonly seen, the tuberculomas in the brain appearing as ring-enhancing lesions point towards wide-spread involvement and calls for urgent treatment. In our case, an 8-month-old infant presented with lymphadenopathy and increasing head circumference. Further diagnostic evaluations led to the diagnosis of military TB. Our case sheds light on diagnosing a case of military TB in an infant in a broad range of differentials.