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A 2 month old child coming with h/o of poor weight gain and fever for 2 weeks.the child was found to have generalised lymphadenopathy and malnourished,no BCG scar,hepatosplenomegaly.otherwise allwork outs are normal.mother found to be retroviral positive and the child does not have a BCG scar.can disseminated BCG tuberculosis be a differential diagnosis.how to confirm
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Since the mother is retroviral positive, first rule out HIV infection in the child as all the findings can be due to HIV.
To prove disseminated Tb, look for evidence of TB. Are there any Xray finding? Does the child have significant axillary LNs for BCG adenitis? Did the child actually receive BCG? Confirmation for Disseminated Tb can only be done by lymph node biopsy.
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