Value of sonography for follow-up of mediastinal lymphadenopathy in children with tuberculosis.
OBJECTIVE
To assess the clinical value of sonography for the follow-up of mediastinal lymphadenopathy in children diagnosed with pulmonary tuberculosis (TB).


METHODS
We conducted a retrospective review of the medical records of 21 children (9 boys, 12 girls) with a mean age of 6 years (range, 7.4 months to 18 years) who had a positive intradermal tuberculin skin test. All patients underwent thorough history-taking, physical examination, frontal and lateral chest radiographs, and sonographic study of the mediastinum. The mediastinum was accessed through the suprasternal and left parasternal approaches. The presence of 1 or more masses with an ovoid or round shape and hypoechoic appearance in the anterior or middle mediastinum was recorded. A comparison was made between the results of the sonographic examination of the mediastinum before administration of anti-TB agents and after 3 months of treatment.


RESULTS
Pulmonary radiographic findings were suggestive of TB in 17 patients and were uncertain in 4 patients. Sonographic examination, however, detected mediastinal lymphadenopathy in all patients. A comparison of pretreatment mediastinal sonograms with those obtained after 3 months of anti-TB treatment showed a marked reduction of lymph node involvement in 17 patients (80.9%). In the remaining 4 patients, mediastinal lymphadenopathy was still present.


CONCLUSIONS
Mediastinal sonography appears to be a valuable tool for the diagnosis of TB and in the monitoring of response to treatment in children.
Bosch-Marcet
Joaquim
J
Department of Pediatrics, Hospital General de Granollers, Avda. Francesc Ribas s/n,E-08400 Granollers, Barcelona, Spain.
Serres-Créixams
Xavier
X
Borrás-Pérez
Victoria
V
Coll-Sibina
Maria Teresa
MT
Guitet-Juliá
Montserrat
M
Coll-Rosell
Elena
E
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018084:Ultrasonography, Interventional
D000995:Antitubercular Agents