Carnazzo Salvatore, Cerruto Carla, Comisi Francesco F
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Pediatric Clinic and Rare Diseases, Microcitemico Hospital "A. Cao", University of Cagliari, Cagliari, Italy.
Radiol Case Rep. 2024 Nov 15;20(1):813-816. doi: 10.1016/j.radcr.2024.10.129. eCollection 2025 Jan.
Tuberculosis (TB) remains a significant global health challenge, particularly within pediatric populations. This article reports the case of a 7-year-old female patient admitted with massive fibrinous pleural effusion secondary to TB, highlighting the key role of ultrasound in disease monitoring and therapeutic guidance. The patient presented with fever, cough, and abdominal pain. Imaging confirmed the presence of pleural effusion and lymphadenopathy. Serial ultrasound assessments demonstrated superior sensitivity compared to CT in characterizing the pleural effusion, leading to the initiation of intrapleural urokinase therapy under ultrasound guidance. The treatment resulted in the successful dissolution of fibrin septations and marked clinical improvement. The discussion explores the diagnostic advantages of ultrasound in pediatric TB, its effectiveness in monitoring therapeutic response, and the utility of localized fibrinolytic therapy. This case highlights the value of ultrasound as a cost-effective, noninvasive, radiation-free tool in the management of pediatric TB, advocating for its increased integration into routine pediatric care.
结核病（TB）仍然是一项重大的全球健康挑战，在儿科人群中尤为如此。本文报告了一名7岁女性患者的病例，该患者因结核病继发大量纤维蛋白性胸腔积液入院，强调了超声在疾病监测和治疗指导中的关键作用。患者出现发热、咳嗽和腹痛。影像学检查证实存在胸腔积液和淋巴结病。与CT相比，系列超声评估在表征胸腔积液方面显示出更高的敏感性，从而在超声引导下启动了胸腔内尿激酶治疗。治疗成功溶解了纤维蛋白分隔并使临床症状显著改善。讨论探讨了超声在儿童结核病中的诊断优势、其在监测治疗反应方面的有效性以及局部纤维蛋白溶解治疗的效用。该病例突出了超声作为一种经济有效、无创、无辐射的工具在儿童结核病管理中的价值，主张将其更多地纳入儿科常规护理中。
