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Pneumonia with pneumatocele formation caused by Mycobacterium tuberculosis: report of one case
1Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, R.O.C.
Insights
Tuberculosis can cause pneumatocele formation in children, a rare complication not typically seen with staphylococcal pneumonia. Early diagnosis and treatment with antituberculous chemotherapy are crucial for recovery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Radiology
Background:
- Pneumatoceles are air-filled spaces in the lungs, commonly associated with Staphylococcus aureus pneumonia.
- Mycobacterium tuberculosis pneumonia rarely leads to pneumatocele formation.
Observation:
- A 1-year-and-5-month-old male presented with pneumonia and radiologically confirmed pneumatocele formation.
- The patient did not respond to empirical antibiotic treatment.
Findings:
- Gastric lavage revealed acid-fast rods, and cultures confirmed Mycobacterium tuberculosis.
- The child was successfully treated with a 6-month course of antituberculous chemotherapy.
Implications:
- Tuberculosis should be considered in pediatric pneumonia cases with pneumatocele formation, particularly those unresponsive to antibiotics.
- This case highlights the importance of considering Mycobacterium tuberculosis in the differential diagnosis of pediatric pneumatoceles.
Abstract:
Pneumatoceles are usually characteristic of staphylococcal pneumonia. They are rarely formed as one of the complications of Mycobacterium tuberculosis pneumonia. We report a 1-year-and-5-month old male child with pneumonia who was confirmed to have the rare complication, pneumatocele formation, by chest radiography and computed tomography. Since the patient did not respond to empiric antibiotic therapy, gastric larvage through a nasogastric tube was performed on three consecutive mornings and, as a result, acid fast rods were found on the three specimens. The cultures subsequently yielded M. tuberculosis. He was finally cured with a 6-month course of antituberculous chemotherapy. We conclude that tuberculosis should be considered in infants or young children with pneumonia that presents radiologically as pneumatocele formation, especially in whom there has been no response to empiric antibiotic therapy.