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587 Cavitating Pulmonary Tuberculosis in Children
  1. G s¸ensoy1,
  2. M Ceyhan2,
  3. N Belet1,
  4. A Karlı1
  1. 1Pediatric Infectious Diseases
  2. 2Radiology, Ondokuz Mayis University, Samsun, Turkey

Abstract

Background and Aim To evaluate the clinical characteristics of children with cavitating pulmonary tuberculosis (PTB).

Patients and methods: We reviewed retrospectively 33 children followed at our hospital with a diagnosis of PTB between April 2007–March 2012 and evaluated the clinical characteristics of patients with cavitary lesions. Tuberculosis (TB) was confirmed by isolation of Mycobacterium tuberculosis (M. tuberculosis) from early morning gastric aspirates, by positive tuberculin skin test (TST), history of exposure to tuberculosis, and/or detection of acid-fast bacilli (AFB) in the early morning gastric aspirates.

Results Seven (21%) of 33 children had cavitating PTB. Median age was 13 years (range 0.4–15.5), with a female/male ratio of 2.5/1. All of them except one patient were ≥12 years old. Three (43%) patients had chronic cough (>4 weeks) and two patients had hemoptysis (1 of them had massive hemoptysis). Contact with a case of TB in the family was available in all of the patients and TST was positive again in 100% of patients. M. tuberculosis was isolated in five (70%) cases. AFB smear positivity was detected in three patients. Chest x-ray and/or thorax computed tomography revealed consolidation in six cases (upper lob involvement in three cases), hilar lymphadenopathy in three and multiple cavities in two cases.

Conclusion Cavitating pulmonary tuberculosis is rare in childhood, but it can be seen especially in older ages. It should be kept on mind that adolescents with cavitary lesions can be potentially contagious and they should be treated with infection control measures.

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