Publication:

Disseminated tuberculosis in an immunocompetent adolescent girl presenting without fever: a master clinical conundrum

Disseminated tuberculosis (TB) in immunocompetent child is rare and poses a diagnostic challenge, especially in the absence of typical systemic features. We present a 14-year-old previously healthy girl with no history of fever, cough, or weight loss, who developed progressive lower limb weakness, constipation, and urinary retention. Imaging revealed spinal intramedullary tuberculoma, multiple brain tuberculomas, and pulmonary involvement. Microbiological confirmation was achieved via bronchoscopy. This case emphasizes the importance of high clinical suspicion, early imaging, and microbiological workup in atypical presentations of TB.