Clinical Course of Endobrochial Tuberculosis Diagnosed by Flexible Bronchoscopy in Children

Jungmin Suh; Joongbum Cho; Jung Hyun Lee; Kangmo Ahn

doi:10.7581/pard.2012.22.2.197

Journal List > Pediatr Allergy Respir Dis > v.22(2) > 1033173

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Suh, Cho, Lee, and Ahn: Clinical Course of Endobrochial Tuberculosis Diagnosed by Flexible Bronchoscopy in Children

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(2): 197-203.

Published online: 30 June 2012

DOI: https://doi.org/10.7581/pard.2012.22.2.197

Clinical Course of Endobrochial Tuberculosis Diagnosed by Flexible Bronchoscopy in Children

Jungmin Suh, MD¹, Joongbum Cho, MD², Jung Hyun Lee, MD³, Kangmo Ahn, MD, PhD²

¹Department of Pediatrics, Sahmyook Medical Center, Seoul, Korea.

²Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

³Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

Corresponding author (kmaped@skku.edu)

Received 19 March 2012 Revised 24 March 2012 Accepted 28 March 2012

Abstract

Purpose

The incidence of endobronchial tuberculosis in children is unknown, due to the inconsistent implementation of bronchoscopy in pediatric patients with pulmonary tuberculosis. In this study, our aim was to determine the incidence and clinical course of endobronchial tuberculosis in children.

Methods

We performed a retrospective chart review of patients less than 18 years of age, who was diagnosed with endobronchial tuberculosis via fiberoptic bronchoscopy.

Results

Out of the 101 patients with pulmonary tuberculosis, 16 patients had endobronchial tuberculosis. The median age at diagnosis was 11.2 years (range, 5 months to 16.1 years). Tuberculin skin test was positive in 9 cases (56.2%), and 6 patients (37.5%) had a history of household contact with tuberculosis. Consolidation lesion was common in the simple chest radiographs of patients with endobronchial tuberculosis. According to the bronchoscopic finding, actively caseating type was most common (43.8%). Nine of the 16 patients of endobronchial tuberculosis progressed to bronchial obstruction and 4 patients underwent pneumonectomy or lobectomy. Fibrostenotic and tumorous type tend to progress to endobronchial obstruction compared with actively caseating type.

Conclusion

The incidence of endobronchial tuberculosis in pediatric pulmonary tuberculosis was 15.8%. Early detection and effective treatment of endobronchial tuberculosis are important to decrease the secondary complication, such as bronchial obstruction.

Keywords: Tuberculosis, Endobronchial tuberculosis, Bronchoscopy, Children

Figures and Tables

Fig. 1

Outcome of the patients with endobronchial tuberculosis according to the types of endobronchial tuberculosis (A) and treatment modalities (B). antiTB, antituberculosis medication.

Table 1

Demographic Characteristics of the Patients with Endobronchial Tuberculosis (n=16)

Table 2

Roentgenographic Findings of Endobronchial Tuberculosis (n=16)

Table 3

Microbial Investigation of the Patients with Endobronchial Tuberculosis

MDR, multidrug resistant.

Table 4

Initial Bronchoscopic Findings of the Patients with Endobronchial Tuberculosis (n=16)

Table 5

Follow-up Bronchoscopic Findings of the Patients with Endobronchial Tuberculosis (n=16)

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