Learning objectives
To provide an overview of the possible spectrum of pediatric tuberculosis (PTB) findings in Chest X-Ray (CXR) and Computed Tomography (CT),
in particularfocusing on intrathoracic PTB.
To correlate the radiological findings with a new classification of PTB.
To emphasize the role of imaging in the evaluation of treatment response.
Background
Increased international travel and immigration have seen PTB rates increase even in traditionally low burden,
industrialized settings,
with roughly a million cases estimated globally each year.
Children are particularly vulnerable to severe disease and death following infection,
and those with latent infection become the reservoir of disease reactivation in adulthood,
fueling the future epidemic [1].
For these reasons,
today PTB is considered a public health emergency.
The changing landscape in which tuberculosis occurs,
as well as the global resurgence,
and the changed spectrum of the...
Imaging findings OR Procedure details
The clinical spectrum of childhood TB reflects differences in the balance between the pathogen and the host immune response,
with more severe disease resulting from either poor or ‘over-exuberant’ attempts to contain the disease.
It remains largely unknown what determines the differences in the host/pathogen interactions that leads to successful containment as opposed to progressive disease,
however age and immunodeficiency represent important factors,
strictly correlated each other.
Two different types of PTB have been described in the extremes of childhood according to differences in host...
Conclusion
CXR and CT are essential diagnostic tools in PTB because of the rarity of clinical signs and complexity of bacteriologic tests in childhood.
Primary TB is the most common form of pulmonary TB in children and lymphadenopathy represents the most common finding.
The new classification of pediatric TB better correlates with disease severity than the traditional distinction in pulmonary and extrapulmonary TB.
CXR and CT are helpful in distinguish severe from non-severe forms of PTB,
leading to different clinical management.
Imaging represent also a valuable...
References
Marais BJ.
Childhood tuberculosis: epidemiology and natural history of disease.
Indian J Pediatr 2011; 78: 321-327.
Delacourt C,
Mani TM,
Bonnerot V et al.
Computed tomography with normal chest radiograph in tuberculous infection.
Arch Dis Child 1993; 69: 430-432.
Uzum K,
Karahan OI,
Dogan S et al.
Chest radiography and thoracic computed tomography findings in children who have family members with active pulmonary tuberculosis.
Eur J Radiol 2003; 48: 258 -262.
Leung AN.
Pulmonary tuberculosis: the essentials.
Radiology 1999; 210: 307-322.
Boloursaz MR,
Khalilzadeh S,...
Personal Information
Mariaelena Occhipinti,
MD
Dept.
of Radiological Sciences
Catholic University of Sacred Heart,
Gemelli Hospital - Rome/IT
mail to:
[email protected]