Abstract
Background: Lymphadenopathy, with or without parenchymal abnormality, is the radiological hallmark of primary tuberculosis (TB) in children. However, lymph node enlargement may pass undetected on plain chest radiographs. Ultrasonography provides complementary information to that obtained by radiographs. Objective: To assess the clinical value of US for the detection of mediastinal lymphadenopathy in children with a positive intradermal tuberculin test. Materials and methods: Thirty-two children with a mean age of 6 years and a positive Mantoux test underwent chest radiography (frontal and lateral) and US (suprasternal and left parasternal access routes). Chest CT was performed at the discretion of the attending physician in six cases. Results: Eleven children had clinical symptoms and 90% a recent contact with a person with active TB. In 90.5% of children with chest radiographic images compatible with TB, coincident findings in the mediastinal US study were found. By comparison, 66.7% of those with normal chest radiography had evidence of mediastinal lymphadenopathy on the US scan. In all cases but one, US and CT findings agreed. Conclusions: Mediastinal US is useful for the detection of enlarged lymph nodes in children with a positive tuberculin reaction and normal chest radiography.
Similar content being viewed by others
References
Vallejo JG, Ong LT, Starke JR (1994) Clinical features, diagnosis, and treatment of TB in infants. Pediatrics 94:1–7
American Thoracic Society (1990) Diagnostic standards and classification of TB. Am Rev Respir Dis 142:725–735
Hilman BC (1993) Pulmonary TB and tuberculous infection in infants, children, and adolescents. In: Hilman BC (ed) Pediatric respiratory disease: diagnosis and treatment. Saunders, Philadelphia, pp 311–319
Snider DE, Rieder HL, Combs D et al (1988) TB in children. Pediatr Infect Dis 7:271–278
Burroughs M, Beitel A, Kawamura A et al (1999) Clinical presentation of TB in culture-positive children. Pediatr Infect Dis 18:440–446
Delacourt C, Mani TM, Bonnerot V et al (1993) Computed tomography with normal chest radiograph in tuberculous infection. Arch Dis Child 69:430–432
Lucaya J, Strife J (2001) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin Heidelberg New York, pp 1–25
Starke JR (1988) Modern approach to the diagnosis and treatment of TB in children. Pediatr Clin N Am 35:441–464
American Thoracic Society and the Centers for Disease Control and Prevention (2000) Diagnostic standards and classification of TB in adults and children. Am J Respir Crit Care Med 161:1376–1395
Omlor GJ (2001) Pulmonary lymphadenopathy. Pediatr Infect Dis 20:437–438
Leung AN, Müller NL, Pineda PR et al (1992) Primary TB in childhood: radiographic manifestations. Radiology 182:87–91
Smuts NA, Beyers N, Gie RP et al (1994) Value of the lateral chest radiograph in TB in children. Pediatr Radiol 24:478–480
Vallejo JG, Starke JR (1996) Intrathoracic TB in children. Semin Respir Dis 11:184–195
Andronikou S, Joseph E, Lucas S et al (2004) CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 34:232–236
Acknowledgement
We thank Marta Pulido, MD, for editing the manuscript and for editorial assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bosch-Marcet, J., Serres-Créixams, X., Zuasnabar-Cotro, A. et al. Comparison of ultrasound with plain radiography and CT for the detection of mediastinal lymphadenopathy in children with tuberculosis. Pediatr Radiol 34, 895–900 (2004). https://doi.org/10.1007/s00247-004-1251-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-004-1251-3