Sara Pecori2, Enrico Valletta3
Scuola di Specializzazione in Pediatria, 1Chirurgia Pediatrica, 2Anatomia Patologica, 3Clinica Pediatrica, Università di Verona
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Key words: Granulomatous peritonitis, Granulomatous appendicitis, Extrapulmonary tuberculosis, Yersinia pseudotuberculosis, Mycobacterium tuberculosis, Immigrants
We describe the case of a 5-year boy, born from Moroccan parents, who underwent surgery for acute appendicitis and granulomatous peritonitis. Histopathological and serological findings were suggestive of Yersinia pseudotuberculosis infection. All investigations (excluding QuantiFERON-TB test) were negative for a Mycobacterium tuberculosis infection. Several months later he developed lumbo-aortic and mesenteric nodal enlargement and pulmonary hilar lymphadenopaty and tuberculin skin test became positive. A four-drug therapy for tuberculosis disease was eventually decided with good clinical response. Difficulties in diagnosing tuberculous peritonitis and need for careful surveillance of people immigrating from countries endemic for tuberculosis are discussed.
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