An unusual combination of extrapulmonary manifestations of tuberculosis in a child

SummaryWe report the case of a 10-year-old girl who presented to the emergency department with acute abdominal pain. She was diagnosed as having extrapulmonary tuberculosis (TB) with multifocal osteomyelitis of the spine and ribs, peritonitis and intestinal involvement. We describe the clinical presentation of this unusual constellation of the disease in the absence of pulmonary involvement in a child and discuss the diagnostic challenges and treatment of these rare forms of TB.

► TB is still a major health problem in many countries.
► TB can present in a variety of ways, with or without pulmonary involvement.
► High index of suspicion is required for early diagnosis of unusual forms of TB.