title: Miliary tuberculosis complicated by pulmonary cavitations and pneumothorax in a 14-month old boy.
abstract: Surgical management of tuberculosis is uncommon in children. We report a case of a 14-month-old boy with miliary tuberculosis and recurrent pneumothorax due to cavities in the left lung. This boy had no previous medical history and was referred to our hospital for a severe pneumonia. Initial chest radiograph showed bilateral miliary pattern. Direct microscopy of gastric lavage showed the presence of tubercle bacilli, providing definitive diagnosis. In spite of effective medication, his status rapidly worsened. A cardiac resuscitation was followed by intubation, and he required high-pressure ventilation for four weeks. He developed left pneumothorax, for which several drainages were performed. Computed tomography revealed a huge cavern system involving the entire lingula and surrounded by the left pneumothorax. Eventually, a massive enlargement of the initial cavity necessitated a thoracotomy and wedge resection.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, Toulouse Cedex, France. q.ballouhey@gmail.com
authors.forename: Quentin
authors.initials: Q
authors.lastname: Ballouhey
authors.forename: Susanne
authors.initials: S
authors.lastname: Lau
authors.forename: Franck
authors.initials: F
authors.lastname: Accadbled
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wahn
authors.forename: Dirk
authors.initials: D
authors.lastname: Kaiser
authors.forename: Karin
authors.initials: K
authors.lastname: Rothe
authors.forename: Klaus
authors.initials: K
authors.lastname: Magdorf
mesh_terms: D005751:Gastric Lavage; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011013:Pneumonectomy; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D017792:Surgical Stapling; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery