Nonresponding Mycobacterial Tuberculosis Infection in a Young Child

Abstract We report a 15-month-old boy, who presented with fever, enlarged lymph nodes, and fast breathing. On evaluation, Mycobacterium tuberculosis sensitive to rifampicin was detected from cervical lymph node and he was started on antitubercular therapy. However, he did not respond to therapy and had worsening symptoms. On repeat radiograph, there were cavitory lesions in both lungs. On excisional lymph node biopsy, Bartonella species was detected. Because of infection with multiple organisms and poor response to therapy, an immunodeficiency workup was performed which led to the diagnosis of chronic granulomatous disease.