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[Reevaluation of pathogenesis of epituberculosis in infants and children with tuberculosis]

Shinya Kondo1, Tomoo Miyagawa, Masaki Ito

  • 1Division of Respiratory Disease, Tokyo Metropolitan Kiyose Children's Hospital, Japan. shinya_kondo@tamahoku-hp.jp

Kekkaku : [Tuberculosis]
|August 19, 2007
PubMed

Insights

Epituberculosis in infants, primarily those under one year old, often develops after tuberculosis treatment begins. Enlarged lymph nodes compressing bronchi and bronchial wall lesions contribute to its formation, as seen in CT imaging and bronchofiberscopy.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Radiology

Background:

  • Epituberculosis pathogenesis requires reevaluation due to outdated studies.
  • Most prior research on epituberculosis is over 50 years old.

Purpose of the Study:

  • To reevaluate the pathogenesis of epituberculosis in infants and children.
  • To investigate the role of lymph node enlargement and bronchial changes in epituberculosis development.

Main Methods:

  • Study included 19 children diagnosed with tuberculosis.
  • Diagnostic tools: CT imaging, bronchofiberscopy, gastric Mycobacterium tuberculosis examination, chest X-ray.
  • Patient age distribution: 12 infants (<1 y/o), 2 (1 y/o), 3 (2 y/o), 2 (4 y/o).

Main Results:

  • Epituberculosis occurred in 68% of patients after starting chemotherapy.
  • CT revealed enlarged mediastinal/hilar lymph nodes compressing bronchi in all patients.
  • Bronchofiberscopy showed bronchial wall mass lesions in 81% of patients.

Conclusions:

  • Epituberculosis predominantly affects infants under one year old, differing from previous reports.
  • CT findings suggest epituberculosis is often atelectasis from lymph node compression of bronchi.
  • Bronchial wall mass lesions from lymph node perforation may also contribute to epituberculosis formation.
Abstract

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