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A proposed radiological classification of childhood intra-thoracic tuberculosis

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Abstract

One of the obstacles in discussing childhood tuberculosis (TB) is the lack of standard descriptive terminology to classify the diverse spectrum of disease. Accurate disease classification is important, because the correct identification of the specific disease entity has definite prognostic significance. Accurate classification will also improve study outcome definitions and facilitate scientific communication. The aim of this paper is to provide practical guidelines for the accurate radiological classification of intra-thoracic TB in children less than 15 years of age. The proposed radiological classification is based on the underlying disease and the principles of pathological disease progression. The hope is that the proposed classification will clarify concepts and stimulate discussion that may lead to future consensus.

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References

  1. Lincoln EM, Sewell EM (1963) Tuberculosis in children. McGraw-Hill, New York, pp 1–327

  2. Wallgren A (1935) Primary pulmonary tuberculosis in childhood. Am J Dis Child 49:1105–1136

    Google Scholar 

  3. Miller FJ, Seal RM, Taylor MD (1963) Tuberculosis in children. Churchill, London, pp 1–310

  4. Ewer K, Deeks J, Alvarez L, et al (2003) Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak. Lancet 361:1168–1173

    Article  PubMed  Google Scholar 

  5. Marais BJ, Gie RP, Schaaf HS, et al (2004) The natural history of childhood intra-thoracic tuberculosis—a critical review of the literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 8:392–402

    CAS  PubMed  Google Scholar 

  6. Blacklock JW (1932) Tuberculosis disease in children: its pathology and bacteriology. Special report series no. 172, British Medical Research Council, pp 1–155

    Google Scholar 

  7. Rich A (1951) The pathogenesis of tuberculosis, 2nd edn. Charles C Thomas, IL, pp 314–880

  8. Wallgren A (1938) Pulmonary tuberculosis: the relation of childhood infection to disease in adults. Lancet I:417–420

    Article  Google Scholar 

  9. Davies PD (1961) The natural history of tuberculosis in children. Tubercle 42 [Suppl]:1–40

    Google Scholar 

  10. Wallgren A (1948) The time-table of tuberculosis. Tubercle 29:245–251

    Google Scholar 

  11. Gedde-Dahl T (1951) Tuberculous infection in the light of tuberculin matriculation. Am J Hyg 56:139–214

    Google Scholar 

  12. Brailey M (1943) Prognosis in white and colored tuberculous children according to initial chest X-ray findings. Am J Public Health 33:343–352

    Google Scholar 

  13. High RH, Nelson WE (1955) Experiences with intra- and extraluminal bronchial tuberculous lesions. Am Rev Tuberc 74:256–266

    Google Scholar 

  14. MacPherson AM, Lutwyche VU (1950) Collapse of the lung associated with primary tuberculous lesions. Thorax 5:1–4

    Google Scholar 

  15. Fish RH, Pagel W (1938) The morbid anatomy of epituberculosis. J Path Bact 47:593–601

    Google Scholar 

  16. Veeneklaas GM (1952) Cause and sequelae of intrapulmonary shadows in primary tuberculosis. Am J Dis Child 83:271–281

    CAS  Google Scholar 

  17. Bentley FJ, Grzybowski S, Benjamin B (1954) Tuberculosis in childhood and adolescence. The national association for the prevention of tuberculosis. Waterlow, London, pp 16–128, 177–213

  18. Hardy JB, Proctor DF, Turner JA (1952) Bronchial obstruction and bronchiectasis complicating primary tuberculous infection. J Pediatr 41:740–755

    CAS  PubMed  Google Scholar 

  19. Jones EM, Peck WM, Willis HS (1946) Bronchiectasis following primary tuberculosis. Am J Dis Child 72:296–309

    Google Scholar 

  20. Agrons GA, Markowitz RI, Kramer S (1993) Pulmonary tuberculosis in children. Semin Roentgenol 28:158–172

    CAS  PubMed  Google Scholar 

  21. Kuhn JP, Slovis TL, Silverman FN, et al (1993) Pulmonary infection. In: Silverman FN, Kuhn JP (eds) Caffey’s pediatric X-ray diagnosis, vol 1, 9th edn. Mosby, St. Louis, pp 540–546

  22. Lamont AC, Cremin BJ, Pelteret RM (1986) Radiological patterns of pulmonary tuberculosis in the paediatric age group. Pediatr Radiol 16:2–7

    CAS  PubMed  Google Scholar 

  23. Freiman I, Geefhuysen J, Solomon A (1975) The radiological presentation of pulmonary tuberculosis in children. S Afr Med J 49:1703–1706

    CAS  PubMed  Google Scholar 

  24. Aderle WI (1980) Radiological patterns of pulmonary tuberculosis in Nigerian children. Tubercle 61:157–163

    Article  PubMed  Google Scholar 

  25. Madhi SA, Huebner RE, Doedens L, et al (2000) HIV-1 co-infection in children hospitalized with tuberculosis in South Africa. Int J Tuberc Lung Dis 4:448–454

    CAS  PubMed  Google Scholar 

  26. Barnes PF, Bloch AB, Davidson PT, et al (1991) Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med 324:1644–1650

    CAS  PubMed  Google Scholar 

  27. Palme IB, Gudetta B, Bruchfeld J, et al (2002) Impact of human immunodeficiency virus 1 infection on clinical presentation, treatment outcome and survival in a cohort of Ethiopian children with tuberculosis. Pediatr Infect Dis J 21:1053–1061

    Article  PubMed  Google Scholar 

  28. McAdams HP, Erasmus J, Winter JA (1995) Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am 33:655–678

    CAS  PubMed  Google Scholar 

  29. Leung AN, Brauner MW, Gamsu G (1996) Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients. Radiology 198:687–691

    CAS  PubMed  Google Scholar 

  30. Weber HC, Beyers N, Gie RP, et al (2000) The clinical and radiological features of tuberculosis in adolescents. Ann Trop Paediatr 20:5–10

    Article  CAS  PubMed  Google Scholar 

  31. Beyers JA (1979) The radiological features of primary pulmonary tuberculosis. S Afr Med J 55:994–997

    CAS  PubMed  Google Scholar 

  32. Morrison JB (1973) Natural history of segmental lesions in primary pulmonary tuberculosis. Long-term review of 383 children. Arch Dis Child 48:90–98

    CAS  PubMed  Google Scholar 

  33. Goussard P, Gie RP, Kling S, et al (2002) Expansile pneumonia caused by Mycobacterium tuberculosis: clinical, radiological end bronchoscopic appearance a series of 20 patients. Eur Resp Soc Conference, Nice

    Google Scholar 

  34. Goo JM, Im J (2002) CT of tuberculosis and nontuberculous mycobacterial infections. Radiol Clin North Am 40:73–87

    PubMed  Google Scholar 

  35. Schaaf HS, Gie RP, Beyers N (2003) Tuberculosis in childhood. In: Davies PD (ed) Clinical tuberculosis, 3rd edn. Arnold, London, pp 154–169

  36. Leung AN, Muller NL, Pineda PR, et al (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91

    CAS  PubMed  Google Scholar 

  37. Du Toit G, Swingler G, Iloni K (2002) Observer variation in detecting lymphadenopathy on chest radiography. Int J Tuberc Lung Dis 6:814–817

    PubMed  Google Scholar 

  38. Delacourt C, Mani TM, Bonnerot V, et al (1993) Computed tomography with normal chest radiograph in tuberculous infection. Arch Dis Child 69:430–432

    CAS  PubMed  Google Scholar 

  39. Andronikou S, Joseph E, Lucas S, et al (2004) CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 34:232–236

    PubMed  Google Scholar 

  40. Ramachandran RS (1968) Tuberculosis in children: experience with 1284 cases. Indian Pediatr 5:564–571

    CAS  PubMed  Google Scholar 

  41. Kwong JS, Carigan S, Kang EY, et al (1996) Miliary tuberculosis. Diagnostic accuracy of chest radiography. Chest 110:339–342

    CAS  PubMed  Google Scholar 

  42. Kim WS, Moon WK, Kim I, et al (1997) Pulmonary tuberculosis in children: evaluation with CT. AJR 168:1005–1009

    CAS  PubMed  Google Scholar 

  43. Im J, Itoh H, Han MC (1995) CT of pulmonary tuberculosis. Semin Ultrasound CT MRI 16:420–434

    CAS  Google Scholar 

  44. Bhargava SK, Saha MM, Agarwal KN, et al (1967) Some observations on the patterns of pulmonary tuberculosis in children. Indian Pediatr 4:262–266

    CAS  PubMed  Google Scholar 

  45. Graham SM, Coulter JB, Gilks CF (2001) Pulmonary disease in HIV-infected children. Int J Tuberc Lung Dis 5:12–23

    CAS  PubMed  Google Scholar 

  46. Rennert WP, Kilner D, Hale M (2002) Tuberculosis in children dying with HIV-related lung disease: clinical-pathological correlations. Int J Tuberc Lung Dis 6:806–813

    CAS  PubMed  Google Scholar 

  47. Matsaniotis N, Kattamis C, Economou-Mavrou C, et al (1967) Bullous emphysema in childhood tuberculosis. J Pediatr 71:703–708

    CAS  PubMed  Google Scholar 

  48. Orlovic D, Smego RA (2001) Paradoxical tuberculous reactions in HIV-infected patients. Int J Tuberc Lung Dis 5:370–375

    CAS  PubMed  Google Scholar 

  49. Narita M, Ashkin D, Hollender ES, et al (1998) Paradoxical worsening of tuberculosis following anti-retroviral therapy in patients with AIDS. Am J Respir Crit Care Med 158:157–161

    CAS  PubMed  Google Scholar 

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Acknowledgements

We thank the US Agency for International Development (USAID) for funding the researcher. This manuscript is in partial fulfilment of a PhD thesis.

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Correspondence to Ben J. Marais.

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Marais, B.J., Gie, R.P., Schaaf, H.S. et al. A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34, 886–894 (2004). https://doi.org/10.1007/s00247-004-1238-0

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  • DOI: https://doi.org/10.1007/s00247-004-1238-0

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