RT Book, Section
A1 Abughali, Nazha
A1 Maxwell, Jessie
A1 Kuyp, Frits van der
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114878917
T1 Pediatric Tuberculosis
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114878917
RD 2024/04/25
AB A  17-month-old  Hispanic  boy  presented  to  the  emergency  department  with  a  2-week  history  of  cough,  wheezing,  fever,  and  weight  loss.  The  child  was  born  in  the  US  and  lives  with  his  dad  and  uncle,  both  employed  as  migrant  farm  workers.  He  was  admitted  to  the  hospital  with  the  diagnosis  of  bacterial  pneumonia  and  asthma  exacerbation.  His  initial  chest  radiograph  (CXR)  showed  right  upper  and  lower  lobe  infiltrates  (Figure  186-1).  He  continued  to  have  high  grade  fever  despite  intravenous  antibiotics.  After  further  history  revealed  that  his  mother  recently  died  of  tuberculosis  (TB),  he  was  immediately  placed  in  respiratory  isolation.  A  tuberculin  skin  test  (TST)  was  positive  with  a  17  mm  of  induration,  and  a  computed  tomography  (CT)  of  the  chest  showed  a  large  lymph  node  compressing  the  trachea  and  the  right  main  bronchus  (Figure  186-2).  Gastric  aspirates  for  acid  fast  bacilli  (AFB)  stain  and  culture  were  obtained  and  he  was  started  on  anti-TB  medications.  The  culture  was  positive  for  Mycobacterium  tuberculosis.  His  father,  sister  and  uncle  all  had  a  positive  TST  and  evidence  of  active  pulmonary  TB.  They  were  referred  expeditiously  for  evaluation  and  treatment.