Imaging recommendations and algorithms for pediatric tuberculosis: part 1—thoracic tuberculosis

Abstract

Tuberculosis (TB) remains a global health problem and is the second leading cause of death from a single infectious agent, behind the novel coronavirus disease of 2019. Children are amongst the most vulnerable groups affected by TB, and imaging manifestations are different in children when compared to adults. TB primarily involves the lungs and mediastinal lymph nodes. Clinical history, physical examination, laboratory examinations and various medical imaging tools are combined to establish the diagnosis. Even though chest radiography is the accepted initial radiological imaging modality for the evaluation of children with TB, this paper, the first of two parts, aims to discuss the advantages and limitations of the various medical imaging modalities and to provide recommendations on which is most appropriate for the initial diagnosis and assessment of possible complications of pulmonary TB in children. Practical, evidence-based imaging algorithms are also presented. Graphical Abstract

Hypercalcemia in a 5-Year-Old Child with Disseminated Tuberculosis: Case Report and Literature Review

“…Diagnosis of tuberculosis in children is usually difficult and mainly based on epidemology and clinical symptomswhich are often nonspecific, Childhood TB can be categorized as TB exposure, TB infection (possible or probable) or confirmed TB disease. 6,8,9 With diagnosis of probable TB infection evidenced by exposure history, clinical and laboratory findings, supported by radiological evidence which revealed peripherally calcified necrotic lung lesion, anterior chest wall abscess collection with rib destruction, multiple eggshell calcified mediastinal and abdominal lymph nodes and multiple hypo enhancing hepatic lesions that exhibit calcification and rim enhancement, she was started with anti-tuberculosis medications with 2RH/4RHZE.…”

Evaluation of radiological capacity and usage in paediatric TB diagnosis: A mixed-method protocol of a comparative study in Mozambique, South Africa and Spain

“…CT scans are regarded as the gold standard for detecting lymphadenopathy in childhood TB. CT scans allow for a clear assessment and staging of complications of lymphadenopathy such as airway obstruction [ 14 ].…”

Current and evolving directions in childhood tuberculosis imaging

“…The specific goals of this current mini-symposium are (1) to discuss the constantly evolving role of medical imaging in the evaluation of childhood TB, (2) to provide systematic, evidence-based recommendations on the appropriate use of various imaging modalities and advanced applications in the diagnosis and follow-up of children with suspected TB, and (3) to review the spectrum of classic imaging patterns of TB in the pediatric population. In the first batch of articles released in August 2023, Bernard Laya and colleagues present the imaging recommendations and algorithms for both pediatric thoracic and extrathoracic TB [4,5], which is a helpful guide for radiologists and clinicians when deciding the most appropriate imaging study for various clinical scenarios. The article by Monica Miranda-Schaeubinger and colleagues presents the evolving role of chest radiographs for diagnosis of pediatric pulmonary TB [6].…”