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Chest radiograph findings in children with tuberculous meningitis

R S Solomons1, P Goussard1, D H Visser2

  • 1Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|January 10, 2015
PubMed

Insights

Tuberculous meningitis (TBM) in children often lacks suggestive chest X-ray (CXR) findings, even in younger patients. This highlights the need for diagnostic approaches beyond standard CXR for accurate TBM diagnosis.

Area of Science:

  • Pediatric infectious diseases
  • Radiology
  • Tuberculosis research

Background:

  • Tuberculous meningitis (TBM) diagnosis relies on clinical, laboratory, and radiological data.
  • Chest X-rays (CXR) are often used to identify signs of tuberculosis (TB) in TBM suspects.

Purpose of the Study:

  • To describe radiological features of intrathoracic TB in children diagnosed with TBM.
  • To evaluate the utility of CXR in diagnosing TBM in pediatric patients.

Main Methods:

  • Prospective evaluation of TBM suspects at Tygerberg Children's Hospital, Cape Town.
  • Analysis of radiological findings on CXR in children diagnosed with TBM.

Main Results:

  • 44% of TBM patients had CXR findings suggestive of TB, with 11% showing disseminated (miliary) TB.
  • Suggestive CXR findings were less common in children aged ≤3 years.
  • Complicated intrathoracic lymph node disease was more frequent in younger children (OR 21.69).

Conclusions:

  • Most children with TBM, particularly the very young, do not exhibit suggestive TB signs on CXR.
  • CXR may not be a reliable sole indicator for TBM diagnosis in children.
  • Further diagnostic strategies are needed for TBM in pediatric populations.
Abstract

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