Radiological aspects in computed tomography as determinants in the diagnosis of pulmonary tuberculosis in immunocompetent infants

Abstract

Objective: To describe the chest computed tomography (CT) findings in immunocompetent children under 36 months of age with pulmonary tuberculosis. Materials and Methods: This was a descriptive case series conducted in the city of Rio de Janeiro, Brazil, between January 2004 and July 2013, involving 20 young children who underwent CT after undergoing chest X-rays that did not provide a definitive diagnosis. Results: All of the participants had lymph node enlargement and consolidations. In 15 cases (75%), the consolidations were accompanied by atelectasis. Pulmonary cavitation was seen in 10 cases (50%), and cavitation within consolidations was seen in 7 (35%). The areas of cavitation and parenchymal destruction were not seen on conventional chest X-rays. Conclusion: The radiological presentation of pulmonary tuberculosis in young children differs from that described in older children and adults. CT is an effective method for the early diagnosis of pulmonary tuberculosis in immunocompetent infants, allowing the rapid institution of specific treatment, which is crucial for halting disease progression, as well as for preventing local and systemic complications.

The epidemiology of pulmonary tuberculosis in children in Mainland China, 2009–2015

“…The most common symptoms of TB in children are associated with the primary syndrome and hilar lymph nodes, which chest X-ray often fails to detect 6 26. For these symptoms, a low-dose CT has better sensitivity and specificity than chest X-ray 27. Considering the high risks of radiation exposure, CT examination should be considered for final diagnosis and differential diagnosis if all other tests are equivocal; it is not a screening test, like chest X-ray 28 29.…”

Mültecilerin kabulünden sonra bir referans çocuk hastanesinde çocukluk çağı tüberkülozu

“…In the half of the patients cavitation was present. [18] Half of our patients had normal chest X-ray and diagnosed with chest CT findings. The most common radiological findings were hilar and mediastinal lymphadenopathy and nodule formation similar to previous reports.…”

Pulmonary tuberculosis in young people

“…All patients had lung consolidations, 50% had cavitations associated with other changes. Parenchymal nodules of diverse diameters were found, but a sole case was miliary [2]. The authors emphasized the importance of the CT for early diagnosis and treatment.…”

“…Brazilian researches have also contributed with their findings about useful determinants in the diagnosis of pulmonary TB in young populations [2,3]. Dos Santos et al described the chest computed tomography (CT) changes detected in 20 immunocompetent children with ages under 36 months, in the Rio de Janeiro city [2]. They studied 12 boys and 8 girls, with a mean age of 18 months and an age range between 1 and 36 months.…”