title: Pediatric pulmonary tuberculoma with a solid pulmonary nodule detected on chest computed tomography.
abstract: A 14-year-old girl underwent a medical checkup for Mycobacterium tuberculosis infection because her grandmother had been diagnosed with pulmonary tuberculosis three months earlier. The interferon-gamma release assay (IGRA) showed a positive result. The patient's chest X-ray findings were normal. Chest computed tomography (CT) showed a single mass lesion in the right lower lobe of the lung. A sputum smear of acid-fast bacilli was positive; however, the polymerase chain reaction results for tuberculosis were negative. We diagnosed the patient with pulmonary tuberculosis based on the fact that she had come in contact with a tuberculosis patient. Six weeks later, a liquid culture examination for acid-fast bacilli was found to be positive and the acid-fast bacillus was identified as M. tuberculosis. The use of chest CT is not routinely recommended in all children suspected of having M. tuberculosis infection. However, IGRA-positive children who report frequent contact with infected individuals should undergo CT tomography if chest X-rays do not show any abnormal shadows.
authors.affiliation: The First Department of of Internal Medicine, Shinshu University School of Medicine, Japan.
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Ushiki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Gen
authors.initials: G
authors.lastname: Ideura
authors.forename: Takashi
authors.initials: T
authors.lastname: Shinbo
authors.forename: Mariko
authors.initials: M
authors.lastname: Sugawara
authors.forename: Mineyuki
authors.initials: M
authors.lastname: Hama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hanaoka
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D013902:Radiography, Thoracic; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014375:Tuberculoma; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*