A forgotten old disease : mediastinal tuberculous lymphadenitis in children

摘要: Objective: The purpose of the study was two-fold: (1) to highlight varied presentation mediastinal tuberculous lymphadenitis (MTL) in children and (2) identify parameters, that may help early diagnosis this condition. Methods: Between January 1995 December 2002, 13 with histological MTL were retrospectively assessed for age at presentation, history exposure TB, presenting symptoms, investigations, initial diagnosis, surgical treatment outcome. Stepwise multiple linear regression analysis used determine potential risk factors MTL. Results: Thirteen presented with: (a) fever, night sweats weight loss (4); (b) acute respiratory distress (2); (c) cough shortness breath (SOB) (5); (d) stridor (1); (e) chest pain (1). TB suspected only 6 (46%) presentation. In other 7 cases (54%) presumed diagnoses were: neuroblastoma (nZ1), metastatic malignancy bronchial polyp bronchogenic cyst (nZ2), foreign body (nZ2). Bronchoscopy diagnostic identifying cheesy material within bronchus organisms on lavage 4 (30%) external compression 2 (15%). Thoracotomy excision lymph node mass necessary treat ascertain 3 (23%). All had complete resolution following anti-tuberculous treatment. clues cohort patients SOB tuberculosis (PZ0.0001) bronchoscopy positive staining acid-fast bacilli (PZ0.0001). Conclusions: Tuberculosis not 54% MTL, they posed dilemma admission. must be as a tool where cannot excluded by radiology or specific skin tests. obstructive symptoms. q 2004 Elsevier B.V. rights reserved.