Katakura S, Imagawa T, Ito S, Miyamae T, Mitsuda T, Ibe M, Aihara Y, Yokota S
Department of Pediatrics, Yokohama City University School of Medicine.
Kansenshogaku Zasshi. 1999 Feb;73(2):130-7. doi: 10.11150/kansenshogakuzasshi1970.73.130.
During the recent 2 years we experienced 5 children (2 months-5 years old) with lung tuberculosis, all of whom had positive tuberculin skin-tests, and were in close contact with their family members who had active tuberculosis. However, no abnormal findings on chest X-ray films were pointed out by 2 independent roentogenologists, and no increased levels of inflammatory markers including WBC numbers, CRP, and ESR were detected in all but one child. Moreover, mycobacterial examination of sputa and/or gastric aspirates by microscope, culture technique, and PCR amplification revealed no causative bacilli in 4 children. To clarify whether these children were affected by Mycobacterium tuberculosis, chest CT scan was applied. Surprisingly, all 5 children were revealed to have abnormal changes including primary complexes in the lung field. Taken together, it is important to pursuit the apparent lung tuberculosis in children with a positive family history and positive tuberculin skin-test.
在最近两年里，我们接诊了5名（年龄在2个月至5岁之间）患有肺结核的儿童，他们结核菌素皮肤试验均呈阳性，且均与患有活动性肺结核的家庭成员有密切接触。然而，两名独立的放射科医生在胸部X光片上均未指出异常发现，除一名儿童外，其他所有儿童的白细胞计数、C反应蛋白和血沉等炎症标志物水平均未升高。此外，通过显微镜检查、培养技术和PCR扩增对痰液和/或胃吸出物进行的分枝杆菌检查显示，4名儿童未发现致病杆菌。为了明确这些儿童是否感染了结核分枝杆菌，我们进行了胸部CT扫描。令人惊讶的是，所有5名儿童均显示有异常变化，包括肺野内的原发综合征。综上所述，对于有阳性家族史和结核菌素皮肤试验阳性的儿童，追查明显的肺结核很重要。
