Abstract
Objective. The purpose of this paper is to present our experience withMycobacterium tuberculosis infections in immunocompetent children.
Subjects and methods. Radiology, pathology, microbiology, and discharge records at two institutions identified the study population. Children who were immunocompromised and those with a positive skin test and no radiological or clinical evidence of active infection were excluded. Active mycobacterial infection was defined by a positive culture, biopsy, or a reactive purified protein-derivative skin test (PPD) with an appropriate clinical presentation and response to therapy and/or known exposure to an adult with active tuberculosis.
Results. There were 22 children in whomMycobacterium tuberculosis (MTb) was identified. Fourteen of the patients with MTb were 5 years of age or younger. The most common sites of radiological involvement were the lungs (15 cases) and the hila (eight cases). Four patients had evidence of extrathoracic MTb infection. Three cases of miliary tuberculosis were identified, all in children less than 9 months of age.
Conclusion. Although pulmonary and/or hilar disease remains the most common radiological presentation of childhood tuberculosis, the radiologist must be aware of the many radiological presentations of childhoodMycobacterium tuberculosis infection, and should have a high index of suspicion with the increasing incidence in both normal and immunocompromised children.
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References
Jereb JA, Kelly GD, Dooley SW jr, Cauthen GM, Snider DE (1991) Tuberculous morbidity in the United States: final data, 1990. MMWR 40: 23–27
CDC (1989) A strategic plan for the elimination of tuberculosis in the United States. MMWR 38:269–272
Starke JR, Jacobs RF, Jereb J (1992) Resurgence of tuberculosis in children. J Pediatr 120: 839–855
Vallejo JG, Ong LT, Starke JR (1994) Clinical features, diagnosis, and treatment of tuberculosis in infants. Pediatrics 94:1–7
Hussey G, Chisholm T, Kibel M (1991) Miliary tuberculosis in children: a review of 94 cases. Pediatr Infect Dis J 10: 832–836
Schaaf HS, Gie RP, Beyers J, Smuts N, Donald PR (1993) Tuberculosis in infants less than 3 months of age. Arch Dis Child 69: 371–374
Schuit KE (1979) Miliary tuberculosis in children. Am J Dis Child 133: 583–585
Jinkins JR (1991) Computed tomography of intracranial tuberculosis. Neuroradiology 33: 126–135
Wallace RC, Burton EM, Barrett FF, Leggiardo RJ, Lasater OE (1991) Intracranial tuberculosis in children: CT appearance and clinical outcome. Pediatr Radiol 21: 241–246
Oliva A, Duarte B, Jonasson O, Nadimpalli V (1990) The nodular form of local hepatic tuberculosis. J Clin Gastroenterol 12: 166–173
Levine C (1990) Primary macronodular hepatic tuberculosis: US and CT appearances. Gastrointest Radiol 15: 307–309
Moskovic E (1990) Macronodular hepatic tuberculosis in a child: computed tomographic appearances. Br J Radiol 63: 656–658
Kawamori Y, Matuis O, Kitagawa K, Kadoya M, Takashima T, Yamahana T (1992) Macronodular tuberculoma of the liver: CT and MR findings. AJR 158: 311–313
Idriss ZH, Sinno AA, Kronfol NM (1976) Tuberculous meningitis in childhood. Am J Dis Child 130:364–367
Agrons GA, Markowitz RI, Kramer SS (1993) Pulmonary tuberculosis in children. Semin Roentgen 28: 158–172
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Strouse, P.J., Dessner, D.A., Watson, W.J. et al. Mycobacterium tuberculosis infection in immunocompetent children. Pediatr Radiol 26, 134–140 (1996). https://doi.org/10.1007/BF01372093
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DOI: https://doi.org/10.1007/BF01372093