Yalaki Zahide, Taşar Medine Ayşin, Yıldız Eren, Zengin Tuğba, Çiftçi Ergin, Dallar Yıldız Bilge
Clinic of Pediatrics, Ankara Training and Research Hospital, Ankara, Turkey.
Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey.
Turk Pediatri Ars. 2018 Sep 1;53(3):189-192. doi: 10.5152/TurkPediatriArs.2018.3908. eCollection 2018 Sep.
In infants, tuberculosis usually progresses as hilar lymphadenopathy and parenchyma changes in lungs; associating cavitary lesions are rare. A six-month-old infant was admitted to our hospital with fever. Physical examination revealed decreased breathe sounds in the right lung. Chest radiograph showed pneumonic infiltration in the right middle lobe. The patient was hospitalized with a diagnosis of lobar pneumonia and antibiotic treatment was started. On the sixth day, because no clinical improvement was observed in the patient, computerized thorax tomography was performed. Tomography revealed multiple lymphadenopathies in the right hilar pretracheal and subcarinal region. The patient's tuberculin and acid-resistant bacteria tests were negative; however, the quantiferon test was positive. Family screening revealed active tuberculosis in the mother. Tuberculosis in infants may present with unusual clinical and radiologic findings, and primary cavitary tuberculosis can also be seen in this age group.
在婴儿中，结核病通常表现为肺门淋巴结肿大和肺部实质改变；伴有空洞性病变的情况很少见。一名6个月大的婴儿因发热入院。体格检查发现右肺呼吸音减弱。胸部X线片显示右中叶有肺炎浸润。该患者因大叶性肺炎诊断入院并开始抗生素治疗。第六天，由于未观察到患者临床症状改善，遂进行了胸部计算机断层扫描。扫描显示右肺门气管前和隆突下区域有多处淋巴结肿大。患者的结核菌素和抗酸杆菌检测均为阴性；然而，结核感染T细胞检测呈阳性。家庭筛查发现母亲患有活动性结核病。婴儿结核病可能呈现不寻常的临床和影像学表现，这个年龄组也可见原发性空洞性结核病。
