Case Report
Childhood bronchial tuberculosis: report of one case and literature review
Abstract
Objective: To explore the early diagnosis of childhood bronchial tuberculosis (BTB).
Methods: The clinical data of a 9-year-old boy with long-term chronic cough were retrospectively analyzed, and the relevant literature was reviewed.
Results: The pediatric patient was suspected to be with bronchial asthma due to long-term chronic cough, and was confirmed to be with “nasopharyngeal tuberculosis” during surgery. Purified protein derivative (PPD) (5 IU) showed moderately positive results. Chest X-ray showed the atelectasis of left lower lobe, which was suspected to be caused by bronchial tuberculosis. Chest CT and three-dimensional airway reconstruction showed atelectasis of left lower lobe, increased air volume of the left upper lung, left deviation of the mediastinum, bronchiolitis obliterans in the left lower lobe, and narrowing of the left upper lobe bronchus, suggesting the presence of bronchial tuberculosis. The bronchoscopy showed necrosis of the left main bronchus and mucosal congestion and edema, and then bronchial tuberculosis was confirmed. In addition to the systemic anti-TB treatment, transluminal interventions including local drug injection and balloon angioplasty under bronchoscope were applied routinely and achieved good effectiveness.
Conclusions: Patients with long-term chronic cough should be cautiously managed in clinical settings. Examinations including PPD test, chest CT, three-dimensional airway reconstruction, and bronchoscopy should be performed as early as possible to confirm the potential existence of bronchial tuberculosis. Meanwhile, appropriate interventional treatment under bronchoscopy should be promptly applied to provide optimal protection of bronchi and lung, restore the damaged lung function, and minimize the complications.
Methods: The clinical data of a 9-year-old boy with long-term chronic cough were retrospectively analyzed, and the relevant literature was reviewed.
Results: The pediatric patient was suspected to be with bronchial asthma due to long-term chronic cough, and was confirmed to be with “nasopharyngeal tuberculosis” during surgery. Purified protein derivative (PPD) (5 IU) showed moderately positive results. Chest X-ray showed the atelectasis of left lower lobe, which was suspected to be caused by bronchial tuberculosis. Chest CT and three-dimensional airway reconstruction showed atelectasis of left lower lobe, increased air volume of the left upper lung, left deviation of the mediastinum, bronchiolitis obliterans in the left lower lobe, and narrowing of the left upper lobe bronchus, suggesting the presence of bronchial tuberculosis. The bronchoscopy showed necrosis of the left main bronchus and mucosal congestion and edema, and then bronchial tuberculosis was confirmed. In addition to the systemic anti-TB treatment, transluminal interventions including local drug injection and balloon angioplasty under bronchoscope were applied routinely and achieved good effectiveness.
Conclusions: Patients with long-term chronic cough should be cautiously managed in clinical settings. Examinations including PPD test, chest CT, three-dimensional airway reconstruction, and bronchoscopy should be performed as early as possible to confirm the potential existence of bronchial tuberculosis. Meanwhile, appropriate interventional treatment under bronchoscopy should be promptly applied to provide optimal protection of bronchi and lung, restore the damaged lung function, and minimize the complications.
