Posted On :
20 Sep 2026
Male boy, 9 years old, presented with anterior cervical lymphadenopathy and fever. Lymph node biopsy showed granulomatous disease, suspicious for tuberculosis. Bone marrow biopsy was nonconclusive. Started antituberculous treatment. Fever subsided spontaneously after biopsy.
There has been a history of travelling to Thailand for the past month. a month later , fever recure again abdominal ultrasonography show hypo echogenic area in spleen CBC : HB 8, ESR 100 blood culture, CSF culture was negative. Chest X-ray is free; echo is normal. Started anti-TB again without improvement. No other clinical manifestations. One week later abdoinal ultrasonic showing hypoechogenic areas, needle guided aspiration showed caseating material. Bone marrow biopsy showing granulomatous inflammation, suspecting mycobacterial infiltration. Mantoux test is negative throughout the course. What is the diagnosis?
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