Primary cavitary tuberculosis in an infant.

Area of Science:

• Pediatrics
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) in infants typically manifests as hilar lymphadenopathy and lung parenchymal changes.
• Cavitary lesions are an uncommon presentation of TB in this age group.

Observation:

• A six-month-old infant presented with fever and decreased breath sounds, initially diagnosed with lobar pneumonia.
• Chest radiography showed right middle lobe pneumonic infiltration, but antibiotic treatment yielded no clinical improvement.
• Computed tomography revealed extensive lymphadenopathy in the hilar, pretracheal, and subcarinal regions.

Findings:

• Tuberculin and acid-fast bacilli tests were negative, but the quantiferon test was positive.
• The infant's mother was diagnosed with active tuberculosis, indicating a likely source of infection.
• The case highlights that primary cavitary tuberculosis can occur in infants, despite its rarity.

Implications:

• Infant tuberculosis diagnosis requires considering atypical presentations beyond typical lymphadenopathy and lung changes.
• Advanced imaging like CT scans is crucial for identifying subtle or unusual TB manifestations in infants.
• Prompt diagnosis and treatment are vital, especially when family members have active tuberculosis, to prevent severe outcomes in infants.