Question
An 8 years old boy presented with dry cough and low grade fever for 6 months, constipation for 2 months with pain on left side of abdomen for 1 month. Uncle had tuberculosis and had died due to same. On examination, he had tenderness in left lumbar region and other systems were normal. He was malnourished with a weight of 14 kg. Chest X-Ray was normal. Ultrasound abdomen showed mild hepatosplenomegaly with long segment thickening of bowel and enlarged mesenteric lymphnodes. HIV ELISA was negative. He was started on antituberculous therapy {ATT}. Three months after ATT, he had ileal perforation and required surgery. A lymphnode biopsy did not grow any acid fast bacilli {AFB} after 6 weeks of culture. He was started on steroids in view of intestinal adhesions and responded to same.