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Bilateral hilar lymphadenopathy due to Chlamydia pneumoniae infection

Andrew Fretzayas1, Maria Moustaki, Konstantinos N Priftis

  • 13rd Department of Pediatrics, University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.

Pediatric Pulmonology
|May 4, 2011
PubMed

Insights

A child with cough and enlarged lymph nodes, initially suspected to have sarcoidosis, was diagnosed with Chlamydia pneumoniae infection. Treatment with erythromycin resolved all symptoms and radiographic findings.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Radiology

Background:

  • Sarcoidosis is an inflammatory disease that can affect multiple organs, often presenting with cough and lymphadenopathy.
  • A family history of sarcoidosis can increase suspicion for the condition in pediatric patients.
  • Differentiating between infectious and inflammatory causes of pediatric lymphadenopathy is crucial for appropriate management.

Observation:

  • A 5-year-old boy presented with persistent cough and bilateral hilar lymphadenopathy.
  • Initial investigations for sarcoidosis were inconclusive.
  • The patient had a family history suggestive of sarcoidosis.

Findings:

  • Serological testing confirmed Chlamydia pneumoniae infection.
  • The child showed a significant clinical response to erythromycin treatment.
  • Chest X-ray findings, including hilar lymphadenopathy, completely resolved after treatment.

Implications:

  • Chlamydia pneumoniae infection should be considered in the differential diagnosis of pediatric cough and lymphadenopathy, even with a family history of sarcoidosis.
  • Early diagnosis and appropriate antibiotic therapy can lead to complete resolution of symptoms and radiographic abnormalities.
  • This case highlights the importance of considering infectious etiologies in pediatric respiratory conditions that mimic granulomatous diseases.

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