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Clinical Profile of Children with Mediastinal Tuberculosis

Zainali Chunawala1, Ira Shah1

  • 1Pediatric TB Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai 400012, India.

Journal of Tropical Pediatrics
|August 21, 2020
PubMed

Insights

Mediastinal tuberculosis (TB) is common in children with extrapulmonary TB. High incidence of drug-resistant TB (DR-TB) necessitates bacteriological confirmation and longer treatment durations, with CT scans aiding follow-up.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Radiology

Background:

  • Mediastinal tuberculosis (TB) is a significant concern in pediatric populations.
  • Understanding its clinical profile is crucial for timely diagnosis and management.

Purpose of the Study:

  • To elucidate the clinical characteristics of pediatric mediastinal TB.
  • To identify associated factors and co-infections in children with mediastinal TB.

Main Methods:

  • Retrospective analysis of pediatric patients diagnosed with mediastinal TB from January 2015 to March 2018.
  • Evaluation of clinical history, physical examination, chest X-ray, and HRCT chest findings.
  • Analysis of factors associated with mediastinal TB and co-existing pulmonary TB (PTB).

Main Results:

  • Mediastinal TB occurred in 4.12% of pediatric TB cases, often associated with extrapulmonary TB (EPTB).
  • Common symptoms included fever (84.5%), positive Mantoux test (68.1%), and cough (48.3%).
  • High-resolution computed tomography (HRCT) chest revealed necrotic caseous mediastinal nodes in all evaluated patients, and 29.3% had drug-resistant TB (DR-TB).

Conclusions:

  • Mediastinal TB is a frequent manifestation of EPTB in children, with approximately one-third having associated PTB.
  • HRCT chest is vital for diagnosis due to frequent abnormalities on chest X-ray.
  • Bacteriological confirmation is essential given the high DR-TB prevalence, and longer treatment durations are often required, guided by follow-up CT imaging.
Abstract

Keywords:
extrapulmonary tuberculosismediastinal tuberculosismediastinal widening

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