PTB airway compression complicated by vascular abnormalities and cardiac involvement: A case series demonstrating diagnosis and management.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI:10.1002/ppul.27351

P Goussard, E Eber, J Janson, A G Gie, B Fourie, C M Jacobs, S S B Venkatakrishna, S Andronikou, S Van der Westhuizen, P Schubert, C Burger, J Verster, L Ebert, E Deininger-Czermak

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引用次数: 0

Abstract

Introduction: Lymphobronchial tuberculosis (LBTB) is a tuberculous lymphadenopathy causing airway compression in young children. While it can occur in older children due to factors such as airway size, wall weakness, and immune reconstitutions, severe airway obstruction is more common in younger children.

Methods: Chest X-rays show airway compression, while bronchoscopy is the gold standard for confirming TB-induced airway compression. Previous research has demonstrated that drug resistance and HIV have no effect on the outcome of children with significant airway compression caused by TB.

Results: This case series describes the management and outcome of three young children who had simultaneous vascular abnormalities and airway obstruction due to pulmonary tuberculosis (PTB). Concomitant PTB and vascular abnormalities are uncommon, even in high-TB-intensity areas, and affected children may present differently and require individualised treatment.

Conclusions: Advanced imaging is critical for detecting complicated cases of airway compression due to PTB in young children, as vascular abnormalities are uncommon. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) may show metabolically active intracardiac lesions. Individualised management plans are required for these children, and echocardiography is critical for patients with disseminated disease.

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血管异常和心脏受累并发 PTB 气道压迫：展示诊断和管理的系列病例。

简介淋巴支气管结核（LBTB）是一种导致幼儿气道受压的结核性淋巴结病。由于气道大小、管壁薄弱和免疫重建等因素，年长儿童也可能出现这种情况，但严重的气道阻塞在年幼儿童中更为常见：方法：胸部 X 光片可显示气道受压，而支气管镜检查则是确认肺结核引起的气道受压的金标准。以往的研究表明，耐药性和艾滋病病毒对肺结核导致气道严重受压的儿童的治疗效果没有影响：本系列病例描述了三名因肺结核（PTB）而同时伴有血管异常和气道阻塞的幼儿的治疗方法和结果。同时伴有肺结核和血管异常的情况并不常见，即使在肺结核高发地区也是如此，患儿的表现可能不同，需要个性化治疗：结论：由于血管异常并不常见，先进的成像技术对于检测幼儿因肺结核导致气道受压的复杂病例至关重要。氟-18脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-18 FDG PET/CT）可显示代谢活跃的心内病变。需要为这些儿童制定个性化的治疗方案，超声心动图检查对播散性疾病患者至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.