Complication Of Primary Tuberculosis Research Articles

Contralateral paradoxical response to chemotherapy in tuberculous pleural effusion

Pleural effusions may occur as a complication of primary tuberculosis or an established pulmonary or extrapulmonary infection. New formation or expansion of a tuberculous lesion during chemotherapy is referred to as paradoxical response. Paradoxical response has been described to occur weeks or months after starting antituberculous chemotherapy for parenchymal lung disease, intracranial tuberculoma, or pleural effusion1-2. To our knowledge only one case of contralateral paradoxical effusion that occurred eight weeks after standard antituberculous chemotherapy has been reported in the literature3. In this paper, we describe a patient who developed contralateral paradoxical pleural effusion six days after standard antituberculous chemotherapy and prednisolone.Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 63-66

Endobronchial Tuberculous Granuloma in Children

Endobronchial tuberculosis is rare in children, in whom it is usually a complication of primary tuberculosis. Endobronchial involvement may adopt several forms, with granuloma being infrequent. Here we report on 10 cases of endobronchial tuberculous granuloma diagnosed and treated in our Paediatric Surgery Service between 1991 and 2004. In 2 cases the presentation was acute and constituted the first manifestation of TB; the remaining patients were undergoing treatment or had been treated for primary TB, and presented with clinical symptoms or radiological signs that led us to suspect endobronchial involvement. In all cases the granuloma was removed by bronchoscopy. Patients received conventional medical TB treatment, with corticoids for 4 weeks following granuloma removal. The clinical course was favourable in all cases and on follow-up we saw no complications. Endobronchial tuberculous granuloma should be borne in mind in children with symptoms or signs of airway obstruction and especially during the course of tuberculosis treatment.

Surgical treatment for pulmonary tuberculosis in childhood

Summary Seventy-one children who were treated for pulmonary tuberculosis at High Wood Hospital between 1949 and 1958 and who had surgical treatment at the London Chest Hospital were selected for study. Eighteen of these were suffering from primary tuberculosis or its complications and 53 had chronic pulmonary tuberculosis. All except two received chemotherapy. The indications for surgery are discussed. Between 1954 and 1958, 3·3 per cent. of children with primary tuberculosis or its complications and 14·6 per cent. of those with chronic pulmonary tuberculosis were selected for surgical treatment. The various surgical procedures employed in treating primary and chronic pulmonary tuberculosis and the results are discussed. In patients selected for surgery resection is considered to be the method of choice, together with adenectomy in the case of enlarged glands causing symptoms. Extra-pleural pneumothorax has been abandoned and thoracoplasty is contra-indicated in children. The relative freedom from post-operative complications and the good radiological results obtained by comparison with similar surgical treatment in adults is emphasised. All the patients were followed up. There were no deaths. Only one child with primary tuberculosis failed to do well and developed renal and cervical glandular tuberculosis three years after operation. Among the children with chronic pulmonary tuberculosis treated surgically only two relapsed, both following extra-pleural pneumothoraces. The importance of adequate chemotherapy is stressed. It is concluded that surgical treatment should be confined to a small number of patients with persistent symptoms due to the various complications of primary tuberculosis, while in children with chronic pulmonary tuberculosis the indications for surgery are the same as those in adults.

Results of specific treatment of miliary tuberculosis in children; a follow-up study of 63 patients treated with antimicrobial agents.

BEFORE antimicrobial therapy miliary tuberculosis was usually a fatal complication of primary tuberculosis. Cases of spontaneous recovery have been reported in children. Wallgren1 described 5 recov...

Some problems in the diagnosis and treatment of pulmonary tuberculosis in childhood

Summary 1. Bronchial involvement by tuberculoushilar nodes is a complication of primary tuberculosis which often leads to bronchiectasis later in life. Such late complication can be prevented by prompt bronchoscopic removal of the obstructing granuloma and the use of antibiotics. Two cases thus treated with success are reported. 2. Chronic nontuberculous infections of the lungs may simulate tuberculosis in symptomatology and roentgenogram appearance. A thorough history is important in the differential diagnosis. 3. Nonpathogenic acid-fast bacilli may be ingested with food and drink; therefore, finding of acid-fast bacilli in the gastric content does not necessarily mean tubercle bacilli. 4. With few exeptions, a persistentnegative tuberculin reaction is a strong evidence against active tuberculosis. Mere isolation of acid-fast bacilli from the gastric content of a tuberculinnegative child does not prove tuberculosis without a pathogenicity test of the organism. To avoid the risk of exposing a child to tuberculosis, admission of such cases to a tuberculosis hospital should be discouraged. 5. Not all acid-fast bacilli found inthe sputum are from the lung. A case is reported in which the nasal discharge was found to be the source of the acid-fast bacilli in the sputum.