Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis.

Autor: Griffith-Richards SB; Department of Radiology, Tygerberg Hospital and University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa. drsteph21@hotmail.com, Goussard P, Andronikou S, Gie RP, Przybojewski SJ, Strachan M, Vadachia Y, Kathan DL
Jazyk: angličtina
Zdroj: Pediatric radiology [Pediatr Radiol] 2007 Aug; Vol. 37 (8), pp. 798-804; quiz 848-9. Date of Electronic Publication: 2007 May 26.
DOI: 10.1007/s00247-007-0496-z
Abstrakt: 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.
Databáze: MEDLINE
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