Denisse Johanna Romero Lorenti, Sharon Irene Valdez Santos, Verónica Alvarado, Diana Stefanía Alcivar Aveiga
Persistent lymphadenopathy in pediatrics represents a diagnostic challenge due to the wide range of infectious etiologies involved; extrapulmonary tuberculosis accounts for 20–30% of pediatric tuberculosis cases, with tuberculous lymphadenitis being one of its most common forms. We present the case of a 1-year-4-month-old male infant with persistent fever, pruritic skin lesions, and progressive cervical and inguinal lymphadenopathy unresponsive to antibiotic therapy. Laboratory tests showed leukocytosis, thrombocytosis, and cervical ultrasound findings of nodal necrosis. Lymph node biopsy revealed caseous and purulent material, and tuberculosis lymphadenitis was confirmed by PCR/DNA testing of the lymph node and purulent secretion. Additionally, seropositivity for Toxocara canis and Bartonella henselae was documented, broadening the differential diagnosis. The patient received anti-tuberculosis therapy and albendazole, with favorable clinical evolution. This case highlights the importance of a syndromic approach and early microbiological confirmation in persistent pediatric lymphadenopathy.