Diagnostic Dilemma

Abdominal lymphnodes and positive mantoux test

A 7½ years old girl had abdominal pain for 10 days. Ultrasound abdomen showed enlarged mesenteric lymphnodes {1.6 x 0.7 cm}. Her mantoux test with 5 TU was positive {16 x 14 mm}. She was treated with Azithromycin for 5 days and repeat ultrasound abdomen did not show any nodes.

Should this child be treated with antituberculous therapy_? How to interpret the mantoux test_?
Expert Opinion :
Thanks for your replies. A positive mantoux test can be due to either previous BCG vaccine, or due to past or recent TB infection or due to atypical myocbacteria. Thus in this child, mantoux is difficult to interpret as it does not tell active TB disease. The child is otherwise asymptomatic for TB. Presence of abdominal nodes does not always point to TB. It could be due to acute mesenteric syndrome and atypical organisms which in this case seems likely as the nodes have subsided following azithromycin.
Answer Discussion :
Manish Bhagat
treatment not needed
12 years ago
my opinion is u treat that patient with AKT for asymptmatic extrapulmonary TT positive.R, O GI cause for lymphadenitis
12 years ago

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