Related Experiment Videos
Tuberculosis presenting as corticosteroid responsive wheezing in infancy.
I C Kitai1, D M Sanders, J Manungo
1Department of Paediatrics, University of Zimbabwe Medical School, Harare.
Tropical and Geographical Medicine
|July 1, 1989
Summary
Persistent wheezing in infants may mask serious conditions like tuberculosis. Steroid treatment can temporarily improve symptoms but may worsen the underlying disease if not properly diagnosed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Persistent wheezing in infants often leads to a diagnosis of reactive airways disease.
- Corticosteroids, such as prednisolone, are commonly used to manage infant wheezing.
- The use of corticosteroids can sometimes mask underlying infections.
Observation:
- A nine-month-old infant with persistent wheezing was treated with oral prednisolone for six months.
- The child initially showed improvement in symptoms with steroid therapy.
- At 15 months, disseminated pulmonary tuberculosis was diagnosed via chest X-ray and tracheal aspirate culture.
Findings:
- Withdrawal of steroids led to a significant worsening of the infant's wheeze and respiratory distress.
- Antituberculous therapy showed a slow response.
- Corticosteroids are recognized as adjuncts in managing bronchial-lymph node tuberculosis.
Implications:
- Wheezing responsive to prednisolone does not automatically indicate hyperreactive airways disease.
- It is crucial to investigate other potential causes of wheezing, especially in developing countries.
- Misdiagnosis and delayed treatment of tuberculosis in infants can have severe consequences.