Pulmonary tuberculosis presenting as ruptured pneumatocele with pnemomediastinum
Abstract
Pneumatoceles occur as a sequelae to acute pneumonia caused by Staphylococcus
aureus. We present a case of 4 month old infant who was a twin with cough, breathlessness for one
month and history of not gaining weight for one month. The child had contact history for tuberculosis.
Chest radiograph was reported as pneumatocele and CT was reported as 'rupture pneumatocele with
pneumo - mediastinum'. Gastric juice aspirate showed 7 AFB in 100 oil immersion fields and thus
confirmed the diagnosis of childhood tuberculosis. Anti - tubercular drugs were started in accordance
to RNTCP 2013 guidelines under 'new case' category. The child, on follow up was found to be in
good compliance with drugs and had gained weight. Chest radiograph was repeated after 4 months
of treatment and showed resolution of pneumatocele. HIs parents and twin brother were screened for
tuberculosis and were found to be negative. INH prophylxis was started for his twin brother.
Full Text:
PDFReferences
Clinical and Radiographic Findings of Pulmonary Tuberculosis in Infants: Bolursaz MR et al; J
Compr Ped. 2013;3(5)
Combating Tuberculosis in Children; Stop TB partnership; WHO
Cavitating pulmonary tuberculosis below age of 2 years; Maniar et al; Indian Pediatrics; volume
-february 1994
Stop TB Partnership Childhood TB Subgroup,World Health Organization, Geneva, Switzerland,
Chapter 1; page 1091 – 1096;int j tuberc lung dis 10(10):1091–1097
Guidelines for management of childhood tuberculosis, TB INDIA 2013 Revised National TB
control programme, Annual status report.
Schaaf HS, Gie RP, Beyers N, Smuts N, Donald PR. Tuberculosis in infants less than 3 months
of age. Arch Dis Child. 1993;69(3):371-4.
Vallejo JG, Ong LT, Starke JR. Clinical features, diagnosis, and treatment of tuberculosis in
infants. Pediatrics. 1994;94(1):1-7.
Pesanti EL. The negative tuberculin test. Tuberculin, HIV, and anergy panels. Am J Respir Crit
Care Med. 1994;149(6):1699-709.
Pneumonia with pneumatocele formation caused by Mycobacterium tuberculosis: report of one
case. Kao HC, Chiu CH, Lin TY, Wang CR. PMID:9553295 [PubMed - indexed for MEDLINE].
Tuberculous pulmonary pneumatocele communicating extrathoracically; Duttaroy et al;
Thorax. 2006 August; 61(8): 738. PMCID: PMC2104690.
Pneumatocele formation in adult pulmonary tuberculosis during antituberculous
chemotherapy: a case report; Liao Wan-Hsiu et al; Journal 2009, 2:8570 doi:10.4076/1757-1626-2-
Schaaf HS, Collins A, Bekker A, Davies PD. Tuberculosis at extremes of age. Respirology.
;15(5):747-63.
Ethambutol dosage for the treatment of children: literature review and recommendations;
P.R.Donald et al; INT J TUBERC LUNG DIS 10(12):1318–1330.
Cantwell M, Snider DE Jr, Cauthen GM, Onorato IM. Epidemiology of tuberculosis in the
United States, 1985 through 1992. JAMA 1994; 272: 535-539.
Hageman J, Shulman S, Shreiber M, Lucks, Yogev R. Congenital tuberculosis. Critical
reappraisal of clinical findings and diagnostic procedures. Pediatrics 1980; 66: 980-984.
Fundamentals of diagnostic radiology, William E. Brant, Clyde A. Helms – 2012; page 1142
Pneumatocele; Author: Denise Serebrisky, MD; Chief Editor: Michael R Bye, MD Medscape
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
An initiative of The Tamil Nadu Dr M.G.R. Medical University