Abstract

Introduction
Extrapulmonary tuberculosis cases may display different clinical symptoms and this causes delay in diagnosis. Nutritional deficiencies, migrations and wars facilitate the development and the spreading speed of the disease. The aim of this article is to examine extrapulmonary tuberculosis patients with different clinical presentations.

Method
Retrospective evaluation of 15 patients who were hospitalized and treated in our pediatric clinic in the last two years, has been adopted as the method of this study.
Results
The average age of our patients was 11.7 ± 4, and six of the patients assessed were of Syrian origin. The common complaints of five patients diagnosed with peritoneal tuberculosis were abdominal pain and bloating. Abdominal ultrasonography of the patients was compatible with diffuse ascites. In two of these patients, Mycobacterium tuberculosis grew in the peritoneal fluid.

The common complaints of our five patients diagnosed with lymph node tuberculosis were swelling in the neck, and all had pulmonary involvement. However, only one patient's lymph node biopsy was compatible with tuberculosis.


One patient with bone tuberculosis applied to our clinic for hip and back pain. Pott’s abscess was observed in the patient's thorax MRI and hip MRI was compatible with tuberculous arthritis.
While being examined due to sterile pyuria attacks, one patient diagnosed renal tuberculosis upon the growth of acid-fast bacilli (AFB) in the urine and M. tuberculosis in the urine culture.
One patient with central nervous system involvement applied to our clinic with clouding of consciousness and headache. The cerebrospinal fluid (CSF) findings of the patient were compatible with tuberculosis and growth was observed in the CSF culture.
One case with miliary tuberculosis had hypercalcemia and pulmonary involvement. The patient's M. tuberculosis DNA PCR test was positive in bronchoalveolar lavage fluid.
Another patient with pericardial tuberculosis applied due to respiratory distress and had cardiomegaly and pericardial effusion.
Nine of our patients also had a history of contact, 12 had purified protein derivative of tuberculin (PPD) (+), and 11 had pulmonary involvement.

Conclusion
Patients were admitted to our outpatient clinic with various clinical symptoms. After careful physical examinations were performed, detailed patient histories taken and laboratory tests performed for differentials, patients were diagnosed with extrapulmonary tuberculosis. It was desired to emphasize that this disease may appear with different clinical presentations in endemic regions like our country.

Key words: Child, extrapulmonary tuberculosis, pulmonary tuberculosis