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Tuberculous mediastinal mass presenting with stridor in a 3-month-old child

Daniel A De Ugarte1, Nina L Shapiro, Holly L Williams

  • 1Division of Pediatric Surgery, UCLA Medical Center, Los Angeles, California, USA.

Insights

A rare case of tuberculous mediastinal mass caused obstructive emphysema in an infant. Surgical removal resolved the infant's breathing difficulties, confirming tuberculosis as the cause.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Intermittent stridor in infants can indicate serious airway obstruction.
  • Mediastinal masses are uncommon in pediatric patients and require thorough investigation.
  • Obstructive emphysema on chest x-ray necessitates evaluation for external airway compression.

Observation:

  • A 3-month-old infant presented with intermittent stridor.
  • Chest x-ray revealed obstructive emphysema.
  • Further imaging identified a mediastinal mass compressing the carina and left mainstem bronchus.

Findings:

  • The mediastinal mass was surgically excised.
  • Histopathological examination confirmed the mass was of tuberculous origin.
  • This diagnosis highlights a rare presentation of pediatric tuberculosis.

Implications:

  • Early diagnosis and surgical intervention are crucial for managing airway compression by mediastinal masses.
  • Tuberculosis should be considered in the differential diagnosis of pediatric mediastinal masses, even in low-prevalence settings.
  • This case underscores the importance of comprehensive diagnostic workups for persistent respiratory symptoms in infants.

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