Primary cavitary tuberculosis in an infant

Zahide Yalaki1, Medine Ayşin Taşar1, Eren Yıldız1

  • 1Clinic of Pediatrics, Ankara Training and Research Hospital, Ankara, Turkey.

Turk Pediatri Arsivi
|November 22, 2018
PubMed

Insights

Pediatric tuberculosis can present unusually in infants, sometimes with rare cavitary lesions. Early diagnosis is key, even with atypical symptoms, to manage infant tuberculosis effectively.

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.

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