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Expansile pneumonia in children caused by Mycobacterium tuberculosis : Clinical, radiological, and bronchoscopic appearances
Author(s) -
Goussard P.,
Gie R.P.,
Kling S.,
Beyers N.
Publication year - 2004
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/ppul.20119
Subject(s) - medicine , pneumonia , bronchoscopy , radiology , tuberculosis , radiography , surgery , mycobacterium tuberculosis , pathology
A cohort of 24 children with expansile pneumonia caused by Mycobacterium tuberculosis is described in mostly HIV‐noninfected children (n = 22). The children presented with nonresolving pneumonia and a swinging fever (83%). On chest radiography, they had dense opacification with bulging fissures mainly in the upper lobes (75%). On computed tomography, the lobes are consolidated, with areas of liquefacation. Other features visible are enlarged mediastinal lymph adenopathy with ring enhancement (100%), cavities (63%), and tracheal compression (71%). On bronchoscopy, bronchi were obstructed by more than 75% in 20 (83%) of cases. Lymph gland enucleation was required in 42% of cases. Phrenic nerve palsy was present in 3 children, of whom 2 underwent diaphragmatic plication. The children received standard antituberculous therapy, to which prednisone (2 mg/kg/day) was added for 1 month. The mortality was 4% after 6 months of therapy. © 2004 Wiley‐Liss, Inc.