Source: Annual Congress 2003 - Clinical features in tuberculosis - I
Disease area: Respiratory infections

Abstract

A 14-year-old boy was admitted to the clinic complaining of persistent productive cough, febrility and weakness. In his anamnesis vitae he reports parotitis and hepatitis. BCG immunised upon birth, while the tuberculin hypersensitivity (Mantoux = 18mm) was detected at the age of 10.
Lung x-ray displays visible cavernous changes in the lung tops (right = 5,5cm; left = 1,5 cm). A six-month treatment regime was applied according to the Guidelines for diagnosis, prevention and treatment TBC in children of the International Union of TBC and Lung Disease (IUATLD; 91) and the National TBC Programme (1998).
Ziehl-Nielsen staining of 8 early morning sputum-specimens showed the presence of acid fast bacilli (AFB) and 2 negative findings (sputum conversion). 8 Luwenstein-Jansen layers were cultivated successfully, while sputum sterilisation was proved by 2 negative cultures.
Serial radiographs showed a minimisation of the cavernae to the form of adhesive changes, while the right lung tomographiae displayed a visible draining bronch. Spirometry confirmed mild mixed lung function disorder. Mycobacterium tuberculosis antibodies were positive and NBT antibodies were decreased. HIV infection tularemia and echinococcus were serologically excluded. Splenomegalia, leucocytosis with neutrophilia, increased sedimentation and LDH were normalised at the end of therapy.
In the course of initial two-month intensive treatment with 4 antituberculotics, drug side effects were shown clinically and biochemically (transaminase, acidum uricum).
The treatment was successfully completed by continuos chemiotherapy phase (sterilisation) until the normalisation of all active disease parameters.

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Citations should be made in the following way:
L. Perovic, S. Brankovic (Nis, Yugoslavia). TBC caverna - case report. Eur Respir J 2003; 22: Suppl. 45, 997

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