Nhiễm khuẩn tiết niệu và viêm phổi kéo dài do lao ở trẻ nhỏ: Báo cáo ca bệnh

Abstract

Confirmed diagnosis of tuberculosis in children remains a challenge. This report describes a 3-month-old boy admitted to the National Children's Hospital due to intermittent fever and cough. He was initially diagnosed with acute otitis media and rhinopharyngitis and was treated with Augmentin for seven days. However, fever continued, and a chest X-ray revealed bronchopneumonia. Despite receiving a two-days course of intravenous third-generation cephalosporin, fever persisted, with leukocytes in the urine (4+) and an increase in CRP levels from 32.25 mg/L to 93.32 mg/L. Consequently, he was transferred to the Nephrology and Dialysis Department with a diagnosis of urinary tract infection and pneumonia, with suspected sepsis. His abdominal CT scan appeared normal, and blood, urine, and nasopharyngeal cultures were negative. After 16 days of treatment with Meronem and Vancomycin, he remained febrile, with mild coughing. His CRP levels had decreased to 23.61 mg/L, but leukocytes in the urine remained (3+). A chest CT scan revealed lesions suggestive of tuberculosis. He was transferred to the Central Lung Hospital for tuberculosis treatment. After two weeks, the child became afebrile, with no cough, negative leukocytes in the urine, and normal CRP levels. He continued to receive outpatient treatment.