Disseminated Mycobacterium bovis infection presenting with cervical lymphadenitis in a 15-year-old girl

A 15-year-old girl presented to the emergency department with symptoms of cervical swelling, weight loss, intermittent fevers, cough, and night sweats. Examination revealed bilateral cervical lymphadenopathy and chest radiography showed lung abnormalities. Further testing confirmed a diagnosis of disseminated Mycobacterium bovis infection, a form of bovine tuberculosis. The patient had regularly consumed unpasteurized milk while in Turkey, which is a common mode of transmission for this infection. Treatment with multiple antibiotics was initiated, and the patient underwent surgery to remove affected lymph nodes. The infection is slowly resolving, and close contacts have tested negative for tuberculosis. Bovine tuberculosis is rare in Canada due to milk pasteurization and cattle testing. Human-to-human transmission is uncommon, and extrapulmonary manifestations, such as cervical lymphadenitis, are common. This case highlights the importance of considering bovine tuberculosis in patients with relevant risk factors and symptoms.