Teo S Y, Ong C L
Department of Diagnostic Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
Singapore Med J. 2006 Mar;47(3):243-9; quiz 250.
A five-year-old girl presented with a history of left neck swelling for one week and right thumb swelling for three weeks. Imaging studies revealed a "collar-stud" abscess in the left side of the neck, massive mediastinal lymphadenopathy with a left anterior chest wall abscess, and right thumb dactylitis that was typical of tuberculosis (TB). Surgical drainage of the left neck swelling revealed acid-fast bacilli. Young children are more susceptible to tuberculous infection, and at greater risk of extrapulmonary spread. A child infected with TB indicates recent transmission, usually from an adult. Good contact tracing is essential. Individuals with HIV infection are also at greater risk of TB and atypical mycobacterial infection as well extrapulmonary TB. The clinical and radiological features of both pulmonary and extrapulmonary TB are discussed, with additional illustrative cases.
一名五岁女童，有左侧颈部肿胀一周及右侧拇指肿胀三周的病史。影像学检查显示左侧颈部有“串珠样”脓肿、伴有左前胸壁脓肿的大量纵隔淋巴结肿大以及典型的结核性右拇指腱鞘炎。左侧颈部肿胀部位手术引流发现抗酸杆菌。幼儿更容易受到结核感染，且肺外播散风险更高。感染结核的儿童提示近期有传播，通常来自成人。良好的接触者追踪至关重要。感染人类免疫缺陷病毒（HIV）的个体患结核病、非典型分枝杆菌感染以及肺外结核的风险也更高。本文讨论了肺结核和肺外结核的临床及放射学特征，并附加了病例说明。
