title: Chest radiograph findings in children with tuberculous meningitis.
abstract: BACKGROUND
  Tuberculous meningitis (TBM) is diagnosed based on a combination of clinical, laboratory and radiological findings, including signs suggestive of tuberculosis (TB) on a standard chest X-ray (CXR).
  
  
  METHODS
  We describe the radiological features suggestive of intrathoracic TB in children diagnosed with TBM during a prospective evaluation of TBM suspects seen at Tygerberg Children's Hospital, Cape Town, South Africa.
  
  
  RESULTS
  Of 84 children treated for TBM, 31 (37%) had 'definite' TBM, 45 (55%) 'probable' TBM and 8 (9%) 'possible' TBM. In total, 37 (44%) TBM patients had CXR findings suggestive of TB, 9 (11%) with disseminated (miliary) TB. Only 1 in 4.39 children aged ≤3 years with TBM had suggestive CXR findings. The presence of complicated intrathoracic lymph node disease was significantly higher in children aged ≤3 years (OR 21.69, 95%CI 2.73-172.67, P < 0.01). Among 6 human immunodeficiency virus infected children, 3 (50%) had intrathoracic lymphadenopathy.
  
  
  CONCLUSIONS
  The majority of the children with TBM, including the very young, did not have signs suggestive of TB on CXR.
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
authors.forename: R S
authors.initials: RS
authors.lastname: Solomons
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Goussard
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, Vrije University Medical Centre, Amsterdam, The Netherlands.
authors.forename: D H
authors.initials: DH
authors.lastname: Visser
authors.affiliation: Marie Bashir Institute for Infectious Diseases and Biosecurity Institute and The Children's Hospital at Westmead, The University of Sydney, Sydney, Victoria, Australia.
authors.forename: B J
authors.initials: BJ
authors.lastname: Marais
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
authors.forename: R P
authors.initials: RP
authors.lastname: Gie
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
authors.forename: J F
authors.initials: JF
authors.lastname: Schoeman
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, Vrije University Medical Centre, Amsterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: van Furth
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006776:Hospitals, Pediatric; D006801:Humans; D008206:Lymphatic Diseases / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D013019:South Africa / Q000453:epidemiology; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000453:epidemiology*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000000981:diagnostic imaging*