Ballouhey Quentin, Lau Susanne, Accadbled Franck, Wahn Ulrich, Kaiser Dirk, Rothe Karin, Magdorf Klaus
Department of Pediatric Surgery, Children's Hospital, Toulouse Cedex, France.
Ann Thorac Cardiovasc Surg. 2012;18(4):355-8. doi: 10.5761/atcs.cr.11.01732. Epub 2012 Jan 31.
Surgical management of tuberculosis is uncommon in children. We report a case of a 14-month-old boy with miliary tuberculosis and recurrent pneumothorax due to cavities in the left lung. This boy had no previous medical history and was referred to our hospital for a severe pneumonia. Initial chest radiograph showed bilateral miliary pattern. Direct microscopy of gastric lavage showed the presence of tubercle bacilli, providing definitive diagnosis. In spite of effective medication, his status rapidly worsened. A cardiac resuscitation was followed by intubation, and he required high-pressure ventilation for four weeks. He developed left pneumothorax, for which several drainages were performed. Computed tomography revealed a huge cavern system involving the entire lingula and surrounded by the left pneumothorax. Eventually, a massive enlargement of the initial cavity necessitated a thoracotomy and wedge resection.
儿童结核病的外科治疗并不常见。我们报告一例14个月大的男孩，患有粟粒性肺结核，并因左肺空洞导致反复气胸。该男孩既往无病史，因重症肺炎转诊至我院。最初的胸部X光片显示双侧粟粒样病变。胃灌洗直接显微镜检查发现结核杆菌，从而确诊。尽管进行了有效的药物治疗，他的病情仍迅速恶化。心脏复苏后进行了插管，他需要高压通气四周。他出现了左侧气胸，为此进行了多次引流。计算机断层扫描显示一个巨大的空洞系统，累及整个舌叶，并被左侧气胸包围。最终，最初空洞的大量扩大需要进行开胸手术和楔形切除术。
