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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Cavitary pulmonary tuberculosis is exceptionally rare in children residing in low tuberculosis (TB) burden regions.
  • This case study focuses on two pediatric patients with cavitary TB in Crete, Greece, a region with a historically low TB incidence.

Observation:

  • Two immigrant children, an 11-year-old immunocompetent girl and an 8-year-old immunocompromised boy, were diagnosed with cavitary pulmonary tuberculosis.
  • These cases represent the only observed instances of cavitary TB within a pediatric population of 103,781 children over a 25-year period in Crete.

Findings:

  • The presentation of cavitary pulmonary tuberculosis in immunocompetent and immunocompromised pediatric immigrants is uncommon in low-burden settings.
  • The rarity of these cases underscores potential challenges in early diagnosis and management.

Implications:

  • Severe forms of tuberculosis, including cavitary disease, may re-emerge even in low-incidence areas, particularly within vulnerable populations.
  • Maintaining Bacillus Calmette-Guérin (BCG) vaccination as part of routine immunization programs is crucial for immigrant populations to prevent severe TB manifestations.