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Relation between smear positivity and imaging findings in children with pulmonary tuberculosis
Maryam Hassanzad1, Mohammad Reza Bolursaz1, Payam Mehrian1
1Department of Pediatric Respiratory Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
High-resolution computed tomography (HRCT) can help identify infectious tuberculosis (TB) in children. Certain HRCT findings like cavities and tree-in-bud patterns indicate smear positivity, aiding in infection control.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Pulmonology
Background:
- Tuberculosis (TB) diagnosis in children often relies on clinical signs and laboratory tests.
- Sputum smear results are crucial for determining infectivity and implementing isolation measures.
- Identifying alternative indicators of infectivity in children with suspected TB is essential for disease control.
Purpose of the Study:
- To investigate the correlation between high-resolution computed tomography (HRCT) imaging features of childhood tuberculosis (TB) and sputum smear results.
- To identify HRCT manifestations that can serve as alternative indicators of infectivity in pediatric TB patients.
Main Methods:
- Retrospective comparative study of 95 children (under 15 years) diagnosed with TB.
- Analysis of HRCT findings and sputum smear/gastric lavage results.
- Multivariate analysis comparing HRCT abnormalities between smear-positive and smear-negative groups.
Main Results:
- Consolidation, tree-in-bud pattern, upper lobe nodular infiltration, and cavitation were prevalent in smear-positive children.
- Lymphadenopathy, consolidation, and collapse were dominant in smear-negative children.
- Smear-positive cases showed postprimary TB patterns, while smear-negative cases exhibited primary TB patterns.
Conclusions:
- HRCT findings such as cavity, tree-in-bud, and upper lobe nodular infiltration are associated with smear positivity in pediatric TB.
- Lymphadenopathy and collapse on HRCT are linked to smear-negative TB in children.
- HRCT imaging can differentiate between primary and postprimary TB patterns and aid in assessing infectivity.
Objective/Background:
We investigated the relationship between high-resolution computed tomography (HRCT) imaging manifestation of tuberculosis (TB) in childhood and the results of sputum smear. The aim of this study was to identify an alternative indicator of infectivity to prevent disease transmission through special isolation methods in children who have a clinical condition that suggests TB.
Methods:
This retrospective comparative study was performed on 95 children under the age of 15years with a diagnosis of TB based on World Health Organization criteria and laboratory data (smear and culture positive for Mycobacterium tuberculosis). Investigations were performed on children admitted to the National Research Institute of Tuberculosis and Lung Disease for detection of TB between 2008 and 2012. Samples were collected from direct smear or gastric lavage method. We also performed HRCT on all of the children. The children were divided into two groups based on the results of their smear test. A multivariate analytical model was used for comparison of HRCT abnormalities in these two groups.
Results:
Consolidation, tree-in-bud pattern, upper lobe nodular infiltration, and cavitation were the most prevalent findings in the positive smear group. Lymphadenopathy, consolidation, collapse, and nodular infiltration in the upper lobe were dominant in the negative smear group.
Conclusion:
We found an association between cavity, tree-in-bud, and upper lobe nodular infiltration, and smear positivity in children with TB. Furthermore, we also found an association between lymphadenopathy and collapse in the negative smear group. Moreover, the positive smear group had radiologic manifestation of postprimary TB, whereas the negative smear group had primary TB manifestation.
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