ROLE OF HIGH RESOLUTION COMPUTED TOMOGRAPHY CHEST (HRCT) IN SUSPECTED CASES OF PAEDIATRIC TUBERCULOSIS WHERE CHEST X-RAY IS NORMAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 38
Abstract
BACKGROUND Childhood TB contributes to a large proportion (15 - 20%) of all TB patients in developing countries. As per National guidelines on diagnosis and treatment of Paediatric Tuberculosis in India, all efforts should be made to demonstrate bacteriological evidence in the diagnosis of paediatric TB, but difficulty in collection of sputum and due to paucibacillary primary disease in children it becomes difficult. A negative Mantoux and normal chest skiagram cannot rule out TB in a child. Better techniques like HRCT scans have advantages over conventional radiographs in diagnosing tuberculosis in paediatric patients and can detect the disease in patients whose chest radiographs are normal or equivocal. The aim of this study is to detect pulmonary lesions in suspected cases of childhood tuberculosis, having normal or equivocal findings on chest x-ray and to detect pulmonary lesions in patients with extrapulmonary tuberculosis. MATERIALS AND METHODS The present cross-sectional study was conducted over a period of one year from November 2006 to October 2007, in the Department of Paediatrics at Shri Maharaja Gulab Singh Hospital in collaboration with Department of Radiodiagnosis, Govt. Medical College, Jammu, J and K, India. Children between age groups 6 months and 18 years who were admitted in the paediatrics ward or referred from paediatric OPD suspected of tuberculosis and having normal or inconclusive chest x-rays were included in the study. RESULTS Out of 34 suspected patients, HRCT findings were suggestive of TB in 28 patients (82.4%). Among them positive Mantoux, gastric lavage smear positive for AFB and lymph node biopsy diagnostic of TB were observed in 16 (57.1%), 3 (10.7%) and 5 (17.8%) respectively. Sputum smear for AFB was not positive in any of these patients. Lymph nodes were present in 26 patients (92.86%). Rim enhancement of lymph nodes, disseminated nodules (Miliary TB), consolidation (parenchymal lesions) and calcification were observed in 10, 2, 6 and 3 patients respectively. 6 out of 34 patients had normal HRCT studies. Overall, sensitivity of HRCT was reported as 100% with comparatively lower specificity. CONCLUSION The sensitivity of HRCT chest is quite high, as it provides additional help in improving the diagnostic accuracy as the yield of AFB is low in children and culture results are time consuming.
Authors and Affiliations
Virender Singh, Deepika Dewan, Tania Kakkar, Manisha Manisha
Keywords
Related Articles
- EP ID EP548113
- DOI 10.14260/jemds/2018/945
- Views 57
- Downloads 0
A PROSPECTIVE STUDY OF MECONIUM ASPIRATION SYNDROME IN NEWBORNS IN A DISTRICT HOSPITAL IN SOUTHERN INDIA
[b] AIM OF THE STUDY: [/b]1. To study the incidence and risk factors of MAS in neonates, 2. To study the outcome of using appropriate respiratory support (CPAP and mechanical ventilation) in neonates with MAS a...
EFFICACY OF SINGLE-DOSE OF DEXAMETHASONE IN REDUCTION OF PAIN, NAUSEA AND VOMITING AFTER LAPAROSCOPIC CHOLECYSTECTOMY- A RANDOMISED CONTROLLED TRIAL
BACKGROUND Dexamethasone is an available and cheap drug and has low complications. There are not enough studies on antiemetic and analgesic effects of dexamethasone after laparoscopic cholecystectomy. The aim of this stu...
PAEDERUS DERMATITIS: A CLINICAL, EPIDEMIOLOGICAL AND THERAPEUTIC STUDY OF 417 CASES
[b]INTRODUCTION:[/b] Paederus dermatitis is an acute irritant contact dermatitis caused by accidental crushing of an insect belonging to the genus Paederus. We came across an epidemic cluster of paederus dermatitits...
EVALUATION OF PLATELET COUNTS AND PLATELET INDICES AND THEIR SIGNIFICANT ROLE IN PRE-ECLAMPSIA AND ECLAMPSIA
[b]BACKGROUND[/b]: Preeclampsia and eclampsia are the most leading cause of maternal mortality in developing countries like ours. The aim of our study is to find out the relation between platelet indices and platelet...
STUDY OF VITAMIN D LEVELS IN PULMONARY TUBERCULOSIS PATIENTS AT A TERTIARY CARE HOSPITAL
BACKGROUND Currently available literature highlights association of hypovitaminosis D with chronic diseases such as diabetes mellitus and systemic hypertension, but there are very few studies on role of vitamin D in pulm...