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Atypical mycobacterial pulmonary disease and bronchial obstruction in HIV‐negative children
Author(s) -
Dore N. D.,
LeSouëf P. N.,
Masters B.,
Francis P. W.,
Cooper D. M.,
Wildhaber J. H.,
Fall A. J.,
Sly P. D.
Publication year - 1998
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199812)26:6<380::aid-ppul2>3.0.co;2-i
Subject(s) - medicine , rifabutin , mantoux test , disease , clarithromycin , tuberculosis , mycobacterium tuberculosis , immunology , respiratory disease , pathology , lung , tuberculin , helicobacter pylori
Atypical mycobacterial infection in HIV‐negative children usually presents with cervical lymphadenopathy. We report on 10 children who are HIV‐negative and who presented with pulmonary disease, in whom either culture‐proven atypical mycobacterium infection (four), positive avian Mantoux test (five), or lack of response to human tuberculosis treatment (one) had been observed. One case was subsequently diagnosed as chronic granulomatous disease and illustrates that children with atypical mycobacterial pulmonary infection should have their immune status fully investigated. Bronchial obstruction was observed in eight cases, and of these, endobronchial disease was found in six children. The diagnosis of atypical mycobacterial disease is difficult, and a negative avian Mantoux test does not exclude the diagnosis. The availability of clarithromycin and rifabutin has offered new therapeutic options in treating atypical mycobacterial pulmonary infection, but management of these cases can be prolonged and difficult. Pediatr Pulmonol. 1998; 26:380–388. © 1998 Wiley‐Liss, Inc.