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Chest Infections |

Clinical Case of a 4-Year-Old South-American Native Boy With Disseminated Tuberculosis

Lilian Pereira, MD; Bruna Ghammachi, MD; Brenda Ferri, MD
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Fundação Santa Casa de Misericordia do Pará, Belem, Brazil


Chest. 2013;144(4_MeetingAbstracts):222A. doi:10.1378/chest.1687121
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Abstract

SESSION TITLE: Infectious Disease Global Case Reports

SESSION TYPE: Global Case Report

PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM

INTRODUCTION: The aim of this paper is to describe a clinical case of a South-American native diagnosed with severe Disseminated Tuberculosis at Santa Casa Hospital in Bélem City. The information needed was obtained from hospital records. With the integration of the indigenous people in modern day society, Tuberculosis has become a hard to control endemic disease. The first group having an incidence four to ten times higher if compared with the latter. The disease is considered to be the second most common cause of death in indigenous groups. Brazil has registered 72,000 new cases annually. Along with twenty-one other countries, it forms a group that reports 90% the tuberculosis cases of the world. Taking Native South-American patients group, patients younger than 15 years old represent 40%, with 70% of this group being younger than the age of 5.

CASE PRESENTATION: Our patient was a 4 year-old indigenous boy with a severe disease presentation. The clinical form was, at first, pulmonary but it later evolved into a disseminated form, including meningoencefalitis. The patient had severe malnutrition as a consequence of the disease's chronic evolution. The diagnosis was confirmed by chest computadorized tomography and ganglionar biopsy, which appeared with a caseous necrosis and BAAR positive reaction. During the hospitalization, bacterial infections were properly treated.

DISCUSSION: Tuberculosis vaccine is a well-known way to prevent severe cases of the disease. Our patient did not receive it just after birth and had contact with people who were receiving treatment for tuberculosis. Permanent contact with bacilliferous people led him to sub-clinical evolution and along with severe malnutrition, avoided the diagnosis by inicial tests.

CONCLUSIONS: The vaccine, which our patient did not receive, is useful to prevent severe cases of TBC. The presented case is according to literature as concern to the age of diagnosis and the most frequent presentation.

Reference #1: 1. MARQUES, A.M.C et al. TUBERCULOSIS AMONG BRAZILIAN INDIGENOUS INDIVIDUALS AGED LESS THAN 15 YEARS-OLD IN STATE OF MATO GROSSO DO SUL. REV. SOC. BRAS. MED. TROPICAL, V. 43, N. 6, P: 700-704, NOV-DEZ, 2010.

Reference #2: 2. AMARANTE, J.M.; COSTA, V.L.A. A TUBERCULOSE NAS COMUNIDADES INDIGENAS BRASILEIRAS NA VIRADA DO SÉCULO. BOLETIM DE PNEUMOLOGIA SANITÁRIA, V.8, N 2, JUL-DEZ, 2000

Reference #3: 3. FERREIRA, S.R.S et al. A TUBERCULOSE E A EXPERIÊNCIA DE UM SERVIÇO DE ATENÇÃO PRIMÁRIA À SAÚDE NO SEU CONTROLE , MINISTÉRIO DA SAÚDE, CAPÍTULO 1, P: 21, 2011.

DISCLOSURE: The following authors have nothing to disclose: Lilian Pereira, Bruna Ghammachi, Brenda Ferri

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