Pediatric pulmonary tuberculoma with a solid pulmonary nodule detected on chest computed tomography

Intern Med. 2014;53(8):913-6. doi: 10.2169/internalmedicine.53.1880. Epub 2014 Apr 15.

Abstract

A 14-year-old girl underwent a medical checkup for Mycobacterium tuberculosis infection because her grandmother had been diagnosed with pulmonary tuberculosis three months earlier. The interferon-gamma release assay (IGRA) showed a positive result. The patient's chest X-ray findings were normal. Chest computed tomography (CT) showed a single mass lesion in the right lower lobe of the lung. A sputum smear of acid-fast bacilli was positive; however, the polymerase chain reaction results for tuberculosis were negative. We diagnosed the patient with pulmonary tuberculosis based on the fact that she had come in contact with a tuberculosis patient. Six weeks later, a liquid culture examination for acid-fast bacilli was found to be positive and the acid-fast bacillus was identified as M. tuberculosis. The use of chest CT is not routinely recommended in all children suspected of having M. tuberculosis infection. However, IGRA-positive children who report frequent contact with infected individuals should undergo CT tomography if chest X-rays do not show any abnormal shadows.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Female
  • Humans
  • Interferon-gamma Release Tests
  • Latent Tuberculosis / diagnosis
  • Polymerase Chain Reaction
  • Radiography, Thoracic
  • Sputum / microbiology
  • Tomography, X-Ray Computed
  • Tuberculoma
  • Tuberculosis, Pulmonary / diagnosis*