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Mycobacterium tuberculosis, a cause of necrotising pneumonia in childhood: a case series

SETTING: Tertiary care hospital, Western Cape, South Africa.DESIGN: Retrospective descriptive study of a case series of necrotising pneumonia (NP) in children associated with Mycobacterium tuberculosis presenting over a 4-year period in a country with high human immunodeficiency virus (HIV) and tube...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2018-06, Vol.22 (6), p.614-616
Main Authors: Jacobs, C., Goussard, P., Gie, R. P.
Format: Article
Language:English
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Summary:SETTING: Tertiary care hospital, Western Cape, South Africa.DESIGN: Retrospective descriptive study of a case series of necrotising pneumonia (NP) in children associated with Mycobacterium tuberculosis presenting over a 4-year period in a country with high human immunodeficiency virus (HIV) and tuberculosis (TB) prevalence.OBJECTIVE: To describe the clinical and radiological features of, and treatment regimens and outcomes in, children with NP.RESULTS: Of 32 children (median age 16.5 months, interquartile range 10-33), 8 (25%) (median age 49 months) had NP associated with M. tuberculosis, 6 of whom were HIV-infected. Chest computed tomography (CT) was diagnostic in all cases: no radiological signs were suggestive of TB. There was no difference in the clinical picture, chest radiography or CT scan between M. tuberculosis-associated and bacterial NP. M. tuberculosis was cultured in 75% of cases; pleural fluid acid-fast bacilli was positive in an additional two cases. Surgery was required in 46% of the M. tuberculosis cases. At follow-up, 50% of these cases had complete radiological resolution similar to bacterial NP.CONCLUSION: This series highlights the fact that M. tuberculosis not only causes acute pneumonia in children, it also results in numerous complications. M. tuberculosis should be considered as a cause of NP in all children, especially HIV-infected children, living in high TB prevalence regions.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.17.0570