Advertisement

Pediatric Radiology

, Volume 37, Issue 8, pp 798–804 | Cite as

Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis

  • Stephanie Barbara Griffith-RichardsEmail author
  • Pierre Goussard
  • Savvas Andronikou
  • Robert P. Gie
  • Stefan J. Przybojewski
  • Melanie Strachan
  • Yousuf Vadachia
  • David L. Kathan
Original Article

Abstract

Background

Cavitating pulmonary tuberculosis (PTB) is generally known as a disease of adults, with children typically having features of primary PTB.

Objective

To group children with PTB and cavities according to possible pathogenesis by evaluating the clinical and radiological findings.

Materials and methods

The clinical and radiological findings in ten randomly selected children with PTB and cavitations on chest radiographs were retrospectively reviewed and evaluated.

Results

Three groups emerged: group 1 (four children) had cavities, usually single and unilateral in the classic upper lobe distribution of postprimary PTB; group 2 (three children) developed progressive primary spread of disease with extensive and bilateral pulmonary cavities; and group 3 (three children) developed cavities secondary to airway obstruction by mediastinal lymph nodes with consequent distal collapse and consolidation. Children in group 1 responded well to treatment and had unremarkable recoveries. Children in group 2 were all below 2 years of age with complicated recoveries. Children in group 3 had frequent complications resulting in one fatality.

Conclusion

Cavities in PTB in children may arise by one of three possible mechanisms with a relatively equal incidence. A study is underway to determine the incidence of cavity formation associated with mediastinal lymphadenopathy and airway obstruction.

Keywords

Lung Tuberculosis Cavitation Children 

References

  1. 1.
    Lamont AC, Cremin BJ, Pelteret RM (1986) Radiological patterns of pulmonary tuberculosis in the paediatric age group. Pediatr Radiol 16:2–7PubMedCrossRefGoogle Scholar
  2. 2.
    Leung AN, Muller NL, Pineda PR et al (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91PubMedGoogle Scholar
  3. 3.
    Marais BJ, Gie RP, Schaaf HS et al (2004) A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34:886–894PubMedCrossRefGoogle Scholar
  4. 4.
    Cremin BJ, Jamieson DH (1995) Childhood tuberculosis: modern imaging and clinical concepts. Springer, Berlin, pp 11, 20, 26, 33, 37, 46, 109Google Scholar
  5. 5.
    Shewchuk JR, Reed MH (2002) Paediatric postprimary pulmonary tuberculosis. Pediatr Radiol 32:648–665PubMedCrossRefGoogle Scholar
  6. 6.
    McAdams HP, Erasmus J, Winter JA (1995) Radiological manifestations of pulmonary tuberculosis. Radiol Clin North Am 33:655–678PubMedGoogle Scholar
  7. 7.
    South African Department of Health (2000) The S.A. tuberculosis control programme-practical guidelines. Pretoria, South Africa, pp 32–37 http://www.capegateway.gov.za/text/2003/tb_guidelines2000.pdf Cited 16/01/2007
  8. 8.
    Marais BJ, Hesseling AC, Gie RP et al (2006) The burden of childhood tuberculosis and the accuracy of community-based surveillance data. Int J Tuberc Lung Dis 10:259–263PubMedGoogle Scholar
  9. 9.
    Kisembo HN, Kawooya MG, Zirembu G et al (2001) Serial chest radiographs in the management of children with a clinical suspicion of pulmonary tuberculosis. J Trop Paediatr 47:276–283CrossRefGoogle Scholar
  10. 10.
    Koh DM, Bell JR, Burkill GJ et al (2001) Mycobacterial infections: still a millennium bug – the imaging features of mycobacterial infections. Clin Radiol 56:535–544PubMedCrossRefGoogle Scholar
  11. 11.
    Weber HC, Beyers N, Gie RP et al (2000) The clinical and radiological features of tuberculosis in adolescents. Ann Trop Paediatr 20:5–10PubMedCrossRefGoogle Scholar
  12. 12.
    Agrons GA, Markowitz RI, Kramer SS (1993) Pulmonary tuberculosis in children. Semin Roentgenol 28:158–172PubMedCrossRefGoogle Scholar
  13. 13.
    Goussard P, Gie RP, Kling S et al (2004) Expansile pneumonia in children caused by Mycobacterium tuberculosis: clinical, radiological and bronchoscopic appearances. Pediatr Pulmonol 38:451–455PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Stephanie Barbara Griffith-Richards
    • 1
    Email author
  • Pierre Goussard
    • 2
  • Savvas Andronikou
    • 1
  • Robert P. Gie
    • 2
  • Stefan J. Przybojewski
    • 1
  • Melanie Strachan
    • 1
  • Yousuf Vadachia
    • 1
  • David L. Kathan
    • 1
  1. 1.Department of RadiologyTygerberg Hospital and University of StellenboschTygerbergSouth Africa
  2. 2.Department of PaediatricsTygerberg Children’s Hospital and University of StellenboschTygerbergSouth Africa

Personalised recommendations