Positive Mycobacterium tuberculosis Gastric Lavage Cultures from Asymptomatic Children With Normal Chest Radiography. (20th October 2020)

• Record Type: Journal Article
• Authors: Donald, Peter R; Ronge, Lena; Demers, Anne-Marie; Thee, Stephanie; Schaaf, H Simon; Hesseling, Anneke C
• Is Part Of: Journal of the Pediatric Infectious Diseases Society. Volume 10:Number 4(2021)
• Page Start: 502
• Page End: 508
• Publication Date: 2020-10-20
• Subjects: acid-fast bacilli -- chest radiography -- Mycobacterium tuberculosis -- pulmonary tuberculosis -- tuberculin skin test; Communicable diseases in children -- Periodicals; Children -- Diseases -- Periodicals; 618.929
• DOI: 10.1093/jpids/piaa113
• Languages: English
• ISSNs: 2048-7193

Abstract

Abstract: Mycobacterium tuberculosis culture from gastric lavage from apparently healthy children following tuberculin skin test conversion, despite normal chest radiography (CR), is well known but is a contentious subject. A consensus statement regarding classification of childhood tuberculosis excluded this condition, stating that more data were needed. To assist in this discussion, we reviewed early publications that reported the occurrence of this phenomenon and early anatomical pathology studies that described changes that occur in children following tuberculosis infection. Pathology studies describe frequent cavitation in primary foci in children from whom positive M. tuberculosis cultures might easily arise. These foci were very small in some children who might have normal CR. Positive cultures might also arise from ulcerated mediastinal lymph nodes that are invisible on CR. Young children with recent infection very likely have active primary pulmonary tuberculosis. Abstract : Consensus pediatric tuberculosis case definitions exclude apparently healthy children with normal chest radiography but from whom Mycobacterium tuberculosis is cultured following tuberculin skin test conversion. However, anatomical pathology and clinical observations suggest that these children have active primary pulmonary tuberculosis.