Diagnostic Dilemma - Pediatric Oncall
Is it TB_?
Author: Pediatric Oncall
A 12 years old child presented with cough for 8 days with breathlessness. She was treated with Azithromycin and Salbutamol to which she responded. Her Chest X-Ray showed right sided calcified perihilar lesions and Mantoux test was positive {20 mm}. She was admitted for bilateral bronchopneumonia 2 months back and at that time Chest X-Ray showed bilateral fluffy shadows in lower zone with negative Mantoux test. At that time, she was treated with Amoxicillin-Clavulanic acid and Clarithromycin to which she responded.
Answers of this discussion
Author :- D Nagesh on 24 December 2013.
Answer :- No.observe and further tests may be conducted

Author :- ARUN CHATTERJEE on 24 December 2013.
Answer :- if ct chest andcbc suggest att may be given

Author :- Jorge Bertran M.D. on 24 December 2013.
Answer :- Quantiferon TB Gold antigen test would be usefull . If not available There is no active tb visible on xray which is not to say it is not hidden somewhere else . However this girl will go out to en endemic area ad could be exposed again . So no I would observe .

Author :- Shakil Shaikh on 25 December 2013.
Answer :- no, close followup required. monitor weight.

Author :- Muhammad Javed on 26 December 2013.
Answer :- Was he given BCG at birth. If not he should be treated for tuberculosis

Author :- drjjtambe on 30 December 2013.
Answer :- we need other parameter like current and previous wt, contact history other general finding

Author :- Saurabh Patel on 25 January 2014.
Answer :- No need of giving ATT as both times she responded to antibiotics and it is paroxysmal cough not persistent which is be present for TB.

Author :- Anil Shukla on 26 January 2014.
Answer :- In my opinion Calcified shadow with strongly positive mantoux does not equal to ATT in our country. Keen follow up required and sputtum for AFB x 3 days should be checked.

Author :- LiasMaria U P on 26 January 2014.
Answer :- no follow up the child look for acquired immuno deficiency

Author :- Catharina M.H. Wolde-Yohannes on 26 January 2014.
Answer :- Quantiferon TB Gold antigen test to confirm diagnosis

1 2 
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.