BACKGROUND: Lymphadenopathy, with or without parenchymal abnormality, is the radiological hallmark of primary tuberculosis (TB) in children. However, lymph node enlargement may pass undetected on plain chest radiographs. Ultrasonography provides complementary information to that obtained by radiographs. OBJECTIVE: To assess the clinical value of US for the detection of mediastinal lymphadenopathy in children with a positive intradermal tuberculin test. MATERIALS AND METHODS: Thirty-two children with a mean age of 6 years and a positive Mantoux test underwent chest radiography (frontal and lateral) and US (suprasternal and left parasternal access routes). Chest CT was performed at the discretion of the attending physician in six cases. RESULTS: Eleven children had clinical symptoms and 90% a recent contact with a person with active TB. In 90.5% of children with chest radiographic images compatible with TB, coincident findings in the mediastinal US study were found. By comparison, 66.7% of those with normal chest radiography had evidence of mediastinal lymphadenopathy on the US scan. In all cases but one, US and CT findings agreed. CONCLUSIONS: Mediastinal US is useful for the detection of enlarged lymph nodes in children with a positive tuberculin reaction and normal chest radiography.
BACKGROUND:Lymphadenopathy, with or without parenchymal abnormality, is the radiological hallmark of primary tuberculosis (TB) in children. However, lymph node enlargement may pass undetected on plain chest radiographs. Ultrasonography provides complementary information to that obtained by radiographs. OBJECTIVE: To assess the clinical value of US for the detection of mediastinal lymphadenopathy in children with a positive intradermal tuberculin test. MATERIALS AND METHODS: Thirty-two children with a mean age of 6 years and a positive Mantoux test underwent chest radiography (frontal and lateral) and US (suprasternal and left parasternal access routes). Chest CT was performed at the discretion of the attending physician in six cases. RESULTS: Eleven children had clinical symptoms and 90% a recent contact with a person with active TB. In 90.5% of children with chest radiographic images compatible with TB, coincident findings in the mediastinal US study were found. By comparison, 66.7% of those with normal chest radiography had evidence of mediastinal lymphadenopathy on the US scan. In all cases but one, US and CT findings agreed. CONCLUSIONS: Mediastinal US is useful for the detection of enlarged lymph nodes in children with a positive tuberculin reaction and normal chest radiography.
Authors: M Burroughs; A Beitel; A Kawamura; K Revai; R Ricafort; K Chiu; R Jacobs; L Riley Journal: Pediatr Infect Dis J Date: 1999-05 Impact factor: 2.129
Authors: Savvas Andronikou; Elaine Joseph; Susan Lucas; Stephen Brachmeyer; George Du Toit; Heather Zar; George Swingler Journal: Pediatr Radiol Date: 2004-01-06
Authors: Sanjay K Jain; Savvas Andronikou; Pierre Goussard; Sameer Antani; David Gomez-Pastrana; Christophe Delacourt; Jeffrey R Starke; Alvaro A Ordonez; Patrick Jean-Philippe; Renee S Browning; Carlos M Perez-Velez Journal: Lancet Infect Dis Date: 2020-06-23 Impact factor: 25.071
Authors: Kara-Lee Pool; Charlotte C Heuvelings; Sabine Bélard; Martin P Grobusch; Heather J Zar; Dorothy Bulas; Brian Garra; Savvas Andronikou Journal: Pediatr Radiol Date: 2017-08-29