Abstract
We present a case of late detection and course of the primary tuberculosis complex in a child who was previously in an unknown contact with a tuberculosis patient at the first year of life. The disease onset simulating pneumonia took place at the age of 1 year 8 months. Hereafter, the child did not have any clinical signs of the disease. At the age of 5 years, the child was examined in connection with the hyperergic reaction to tuberculin: the results of computed tomography revealed calcinated foci in the lung tissue and calcifications in the intrathoracic lymph nodes; bronchoscopy revealed infiltrative bronchial tuberculosis. Surgery was performed: video-assisted thoracoscopy, resection of C9,10 part of the left lung with precision removal of the focus in its C6 segment, extirpation of bifurcation, and left bronchopulmonary lymph nodes. The results of the histological examination indicated the chronic course of the tuberculosis process with formation of bronchiectasis and presence of bronchonodular fistulas. After surgery and the main course of antituberculous therapy, a clinical cure with small residual changes was achieved.
Highlights
Представлен случай позднего выявления и течения первичного туберкулезного комплекса у ребенка, находившегося в ранее неизвестном контакте с больным туберкулезом на 1-м году жизни
We present a case of late detection and course of the primary tuberculosis complex in a child who was previously in an unknown contact with a tuberculosis patient at the first year of life
At the age of 5 years, the child was examined in connection with the hyperergic reaction to tuberculin: the results of computed tomography revealed calcinated foci in the lung tissue and calcifications in the intrathoracic lymph nodes; bronchoscopy revealed infiltrative bronchial tuberculosis
Summary
В пятилетнем возрасте ребенок обследован в связи с гиперергической реакцией на туберкулин: по результатам компьютерной томографии выявлены кальцинированные фокусы в ткани легкого и кальцинаты во внутригрудных лимфатических узлах; при бронхоскопии — инфильтративный туберкулез бронхов. (For citation: Petrakova Irina Yu., Gubkina Marina F., Berezovsky Yury S., Bagirov Mamed А., Yukhimenko Natalya V. При контрольной бронхоскопии (от 30.10.2013 г.) к 3-му мес лечения отмечена значительная положительная динамика в виде регресса инфильтративных изменений в Б8–10 левого легкого. У ребенка в исходе первичного туберкулезного комплекса имело место формирование больших остаточных изменений в виде множественных туберкулем нижней доли левого легкого, множественных кальцинатов во внутригрудных лимфатических узлах, пневмофиброза в нижней доле левого легкого, что требовало оперативного лечения для уменьшения риска рецидива заболевания.
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