ABSTRACT
Infant small-bowel intussusceptions, most of the time idiopathic, may exceptionally reveal a severe digestive disease. We report the case of a 4-month-old infant who presented multiple and simultaneous ileal intussusceptions associated with severe acute gastroenteritis. Initially, the infant showed a protein-losing enteropathy with a clear alteration of the general state of health and undocumented fever, resistant to broad-spectrum antibiotic therapy. Skin and splenic nodules associated with hepatosplenomegaly and pancytopenia set in progressively. The etiologic evaluation led to the diagnosis of a Mycobacterium bovis BCG infection related to severe combined immune deficiency. The treatment consisted in anti-tuberculosis quadruple therapy in association with immunoglobin supplementation. Secondarily, the patient underwent gene therapy in a clinical trial. An early BCG vaccine in the first weeks of life, before the outbreak of infection revealing the immune deficiency, is a risk factor in triggering a disseminated BCG infection in immunodepressed infants. This clinical case is the first reported of severe combined immune deficiency revealed by small-bowel intussusceptions related to a disseminated BCG infection.
Subject(s)
Ileal Diseases/microbiology , Intussusception/microbiology , Mycobacterium bovis , Severe Combined Immunodeficiency/complications , Tuberculosis/etiology , Humans , Infant , Male , RecurrenceABSTRACT
Minor salmonellosis is due to Gram-negative bacilli, which usually cause enterocolitis with potentially severe complications. We report on a case of a clinically uncommon presentation of Salmonella enterica serovar typhimurium infection in an 8-year-old child who presented with acute abdominal pain. We discuss clinically uncommon presentations of salmonella disease in children, as well as its pathology and radiology.
