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 72
- Downloads 0
EXPERIENCE OF INGUINAL HERNIA REPAIR IN 230 PATIENTS BY LICHTENSTEIN TECHNIQUE
BACKGROUND The main aim of the surgeon is to lower the recurrence rate while dealing the defect in inguinal canal. Lichtenstein technique has opened a new era in such repairs. In our study we have evaluated 230...
STUDY TO DETERMINE OVERALL EXPERIENCE OF WOMEN UNDERGOING REGIONAL ANAESTHESIA FOR CAESAREAN SECTION
BACKGROUND The choice of anaesthesia for caesarean section depends on many factors including the indication for the caesarean section, whether the procedure is emergency or elective, NBM status of the patient, preoperati...
ELECTROLYTE DISTURBANCES IN CRITICALLY ILL CHILDREN ADMITTED TO PAEDIATRIC TERTIARY CARE CENTRE
BACKGROUND To study the incidence, aetiology and length of ICU stay in children admitted to Paediatric Intensive Care Unit with electrolyte disturbances. MATERIALS AND METHODS Descriptive prospective study in children ag...
A STUDY OF SPIROMETRIC LUNG FUNCTION TETS AND ITS CORRELATION WITH HIGH RESOLUTION COMPUTED TOMOGRAPHY IN PATIENTS OF RHEUMATOID ARTHRITIS
Rheumatoid arthritis is disease which usually starts as an insidious symmetrical polyarthritis often with non specific systemic symptoms. Pleuropulmonary involvement is a important cause of morbidity and mortal...
FIBROMA OF METACARPAL- RARE PRESENTATION
Benign and malignant affections of bone is not uncommon entity. Both types of lesions are seen in both sexes and all age groups. Ossifying fibroma is a rare, benign, slow-growing bone tumor. Tumor has a high re...