Computerised tomography findings of lymphobronchial tuberculosis in children: a comparison between infants and older children
Date
2015
Authors
Hanekom, Heleen
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Abstract
INTRODUCTION: Pulmonary tuberculosis (TB) in children is characterised by mediastinal
and hilar lymphadenopathy. Lymphobronchial TB (LBTB) describes the situation where
tuberculous lymph nodes affect the airways by compression or erosion. Infants may be
more susceptible to severe complications due to their specific airway anatomy and
immature immune systems.
AIM: The purpose of this study was to compare the computerised tomography (CT)
findings of infants and children older than 12 months with LBTB to determine whether
infants are more severely affected in terms of bronchial compression secondary to
mediastinal lymphadenopathy and the complications thereof.
METHOD: The CT scans of 98 children (< 13 years) with LBTB were reviewed
retrospectively by a paediatric radiologist for a previous study and the results captured in
a database. The relevant data was extracted from the existing database and the two age
groups were compared with regard to lymphadenopathy, airway narrowing and
parenchymal complications.
RESULTS: Of the 98 patients, 51% were infants. There was no statistically significant
difference between infants and children older than 12 months with reference to the
frequency and distribution of airway compressions, lymphadenopathy and parenchymal
findings. However, there was a statistically significant difference (p<0.05) in the number
of infants with complete compressions when compared to the older children. Infants also
had a 1.9 times higher risk than older children, of having complete compressions.
CONCLUSION: As opposed to older children, infants’ airways are more susceptible to
complete airway compression as a result of LBTB. This is due to airway size and anatomic
development. We therefore recommend that when infants present with symptoms of
airway compression secondary to LBTB, they should be imaged using CT scanning and
managed urgently.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of
Master of Medicine in Diagnostic Radiology.
Johannesburg, 2015