CASE REPORT   

Il Giornale Italiano di Radiologia Medica 2019 Settembre-Ottobre;6(5):485-91

DOI: 10.23736/S2283-8376.19.00203-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Integrated imaging in the diagnosis of a pediatric case of extrapulmonary tuberculosis associated with HIV infection

Laura GABRIELI ✉, Mariantonietta MONTEDURO, Annarita MILELLA, Federica LARICCHIA, Antonio A. STABILE IANORA

Unit of Radiodiagnostics, Aldo Moro University of Bari, Bari, Italy

In developing countries, tuberculosis (TB) is spread in areas with inadequate socio-economic and hygienic-sanitary conditions. Currently, in the West, TB affects the elderly population mostly. The increased incidence of the disease appears to be related to the ever more widespread migratory phenomena and, often, it’s associated with HIV in the young people. In its different forms (pulmonary, miliary, scrofulous, intestinal, meningeal, osteo-articular) TB is caused by slow-growing bacteria belonging to the genus Mycobacterium. Primarily, they can be localized in the abdomen (which can also be considered secondarily localization by blood diffusion from active pulmonary outbreaks or by contiguity from adjacent organs). Abdominal TB can affect the gastrointestinal tract, peritoneum, nodes, mesentery and parenchymatous organs. The diagnosis of intestinal TB is very difficult because the disease is responsible for a non-specific symptomatology and can pose problems of differential diagnosis with other granulomatous diseases such as Crohn’s disease. The article illustrates the most striking imaging findings that have led to the suspicion of intestinal diagnosis in a 16-year-old immunocompromised and HIV+ patient, born in Africa and resident in Italy for 3 years. The knowledge of clinical data was fundamental for the formulation of a correct diagnostic hypothesis, also allowing a more suitable therapeutic management of the patient.

KEY WORDS: Tubercolosis; Mycobacterium tuberculosis; Diagnostic imaging