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Sonographic Findings of Abdominal Tuberculosis in Children With Pulmonary Tuberculosis

Sabine Bélard1, Tom Heller, Viyanti Orie

  • 1From the *Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa; †Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; ‡Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, and §Berlin Institute of Health, Berlin, Germany; and ¶Lighthouse Clinic, Kamuzu Central Hospital, Lilongwe, Malawi.

The Pediatric Infectious Disease Journal
|March 24, 2017
PubMed

Insights

Pediatric pulmonary tuberculosis (TB) in children frequently involves abdominal complications, including lymphadenopathy and splenic microabscesses. These findings highlight the need for comprehensive abdominal evaluations in children diagnosed with pulmonary TB.

Area of Science:

  • Pediatric Infectious Diseases
  • Radiology and Imaging
  • Mycobacterial Infections

Background:

  • Pulmonary tuberculosis (TB) is a significant global health concern in children.
  • Extrapulmonary manifestations of TB, particularly abdominal involvement, can complicate diagnosis and treatment.
  • Ultrasound is a valuable imaging modality for evaluating abdominal pathology in pediatric patients.

Purpose of the Study:

  • To investigate the prevalence of abdominal tuberculosis (TB) complications in children diagnosed with pulmonary TB.
  • To assess the association between abdominal TB findings and human immunodeficiency virus (HIV) infection.
  • To determine the utility of ultrasound in identifying abdominal TB in pediatric pulmonary TB cases.

Main Methods:

  • Retrospective analysis of ultrasound reports from 102 children with confirmed or clinically diagnosed pulmonary tuberculosis.
  • Categorization of findings into TB-suggestive abdominal lymphadenopathy and splenic microabscesses.
  • Statistical analysis to determine associations between imaging findings and HIV status.

Main Results:

  • Abdominal lymphadenopathy suggestive of TB was observed in 64% and 36% of two analyzed subgroups.
  • Splenic microabscesses were detected in 44% and 13% of the respective subgroups.
  • Splenic microabscesses showed a statistically significant association with HIV infection (P = 0.041).

Conclusions:

  • Pulmonary tuberculosis in children is frequently complicated by abdominal TB manifestations.
  • Ultrasound is effective in detecting abdominal TB, including lymphadenopathy and splenic microabscesses.
  • The presence of splenic microabscesses may indicate a higher risk in HIV-coinfected children.

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