Radiologic Manifestation of Pulmonary Tuberculosis in Children Admitted in Pediatric Ward-Massih Daneshvari Hospital: A 5-Year Retrospective Study
Despite the extensive preventive and therapeutic measures present against tuberculosis (TB), this disease still remains as one of the important causes of mortality and morbidity in the world. Considering the high incidence of TB in children, rareness of its' clinical features and complexity of bacteriologic diagnosis in this age group paraclinical studies, especially radiologic evaluations, is useful for reaching a final diagnosis. This 5 year study was conducted in National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Massih Daneshvari Hospital, Tehran, Iran. This retrospective study was conducted on 70 children (43 (61%) female and 27 (38.5%) male) aged between 5 months to 15 years old during a five year period (from 2001-2006) in pediatric ward. It was performed on children who were confirmed to have TB by various clinical, bacteriologic and radiologic features and tuberculin skin test. We studied the radiologic features of pulmonary TB in these children. Right lung involvement was observed in 65%, left lung 23% and bilateral involvement was detected in 12%. Also middle and superior lobes were the most common lobes affected. The commonest radiographic feature was hilar (mediastinal) lymphadenopathy; 70% detected on chest x-ray (CXR) and 85% on CTscan. Lymph nodes on right side were affected more; 25% were calcified. Also nodular infiltration of lung parenchyma was observed in 35% of CXRS and 61% of CTscans. This was followed by patchy consolidation detected in 25% and 35% of CXRs and CTscans respectively. We also observed that children <3yr. of age had the highest lymph node involvement but the least parenchymal lesions as compared to older children. It is concluded that primary TB is the most common form of pulmonary TB in children. This could be in the form of hilar lymphadenopathy with or without lung parenchymal involvement. Also radiologic features could provide valuable information in regard to diagnosis, treatment and follow-up of pulmonary TB in children.
Leung AN, Müller NL, Pineda PR, FitzGerald JM. Primary tuberculosis in childhood: radiographic manifestations. Radiology 1992;182(1):87-91.
Andreu J, Cáceres J, Pallisa E, Martinez-Rodriguez M. Radiological manifestations of pulmonary tuberculosis. Eur J Radiol 2004;51(2):139-49.
Franco R, Santana MA, Matos E, Sousa V, Lemos AC. Clinical and radiological analysis of children and adolescents with tuberculosis in Bahia, Brazil. Braz J Infect Dis 2003;7(1):73-81.
Manual de Normas para o Controle da Tuberculose. Brasila, Ministerio da Saude-Brasil, 2006.
Starke JR, Taylor-Watts KT. Tuberculosis in the pediatric population of Houston, Texas. Pediatrics 1989;84(1):28-35.
Nolan RJ Jr. Childhood tuberculosis in North Carolina: a study of the opportunities for intervention in the transmission of tuberculosis to children. Am J Public Health 1986;76(1):26-30.
Starke JR. Modern approach to the diagnosis and treatment of tuberculosis in children. Pediatr Clin North Am 1988;35(3):441-64.
Snider DE Jr, Rieder HL, Combs D, Bloch AB, Hayden CH, Smith MH. Tuberculosis in children. Pediatr Infect Dis J 1988;7(4):271-8.
Weber AL, Bird KT, Janower ML. Primary tuberculosis in childhood with particular emphasis on changes affecting tracheobronchial tree. AJR 1968;103:123-32.
Berger HW, Granada MG. Lower Lung field tuberculosis. Chest 1974;65(5):522-6.
Havlir DV, Barnes PF. Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med 1999;340(5):367-73.
Basta PC, Alves LC, Coimbra Júnior CE. Radiographic patterns of pulmonary tuberculosis among the Suruí indians of Rondônia, Amazonia. Rev Soc Bras Med Trop 2006;39(2):221-3.
Freiman I, Geefhuysen J, Solomon A. The radiological presentation of pulmonary tuberculosis in children. S Afr Med J 1975;49(41):1703-6.
Wong KS, Huang YC, Lin TY. Radiographic presentation of pulmonary tuberculosis in young children. Acta Paediatr Taiwan 1999;40(3):171-5.
Milković D, Richter D, Zoricić-Letoja I, Raos M, Koncul I. Chest radiography findings in primary pulmonary tuberculosis in children. Coll Antropol 2005;29(1):271-6.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.