{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:12:48Z","timestamp":1780506768894,"version":"3.54.1"},"reference-count":10,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,24]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>Tuberculosis (TB) is an important public health problem in developing countries. In India, despite substantial efforts targeting TB and its associated risk factors, the number of cases remains high with 2.7 million new cases per year with a minimum 10% case contributed by paediatric TB. Disseminated TB has been increasingly recognised in children in recent times due to the increased prevalence of immune suppression secondary to AIDS and immunosuppressive therapies for various medical disorders and increasing awareness. Here we describe a 5-year-old girl who presented with fever of unknown cause, and her diagnosis of disseminated TB was delayed due to atypical presentation and the paucibacillary nature of paediatric TB. It was a bone marrow examination report which led us to clinch the diagnosis. The case highlights the difficulty in diagnosing disseminated TB and the importance of bone marrow examination in such cases.<\/jats:p>","DOI":"10.1136\/bcr-2020-237192","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T23:30:29Z","timestamp":1607902229000},"page":"e237192","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Disseminated tuberculosis in children\u2014a difficult diagnose depends on how far we can go"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-2184","authenticated-orcid":false,"given":"Siyaram","family":"Didel","sequence":"first","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Purohit","sequence":"additional","affiliation":[{"name":"Pathology and Lab Medicine, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varuna","family":"Vyas","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2365-8097","authenticated-orcid":false,"given":"Prawin","family":"Kumar","sequence":"additional","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"2025082713074521000_13.12.e237192.1","first-page":"790","article-title":"Significance of haematological manifestations in patients with tuberculosis","volume":"49","author":"Singh","year":"2001","journal-title":"J Assoc Physicians 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children with suspected disseminated mycobacterial disease","volume":"15","author":"Rose","year":"2011","journal-title":"Int J Tuberc Lung Dis"},{"key":"2025082713074521000_13.12.e237192.6","first-page":"597","article-title":"Pancytopenia in disseminated tuberculosis","volume":"33","author":"Yadav","year":"1996","journal-title":"Indian Pediatr"},{"key":"2025082713074521000_13.12.e237192.7","doi-asserted-by":"publisher","DOI":"10.1080\/09273940600976946"},{"key":"2025082713074521000_13.12.e237192.8","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1053\/j.semnuclmed.2016.12.003","article-title":"18\n               F-FDG-PET\/CT Imaging of Thoracic and Extrathoracic Tuberculosis in Children","volume":"47","author":"Pelletier-Galarneau","year":"2017","journal-title":"Semin Nucl Med"},{"key":"2025082713074521000_13.12.e237192.9","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3345\/kjp.2016.59.1.43","article-title":"Tuberculosis-Associated hemophagocytic lymphohistiocytosis in adolescent diagnosed by polymerase chain reaction","volume":"59","author":"Seo","year":"2016","journal-title":"Korean J Pediatr"},{"key":"2025082713074521000_13.12.e237192.10","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:07:53Z","timestamp":1756325273000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":10,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,13]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bcr-2020-237192"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237192","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}