Type:
Educational Exhibit
Keywords:
Thorax, Lung, Lymph nodes, CT, Conventional radiography, Computer Applications-Detection, diagnosis, Cavitation, Infection
Authors:
M. Occhipinti1, A. R. Larici1, A. del Ciello1, P. Franchi1, E. Devicienti2, L. Calandriello1, F. Maggi1, L. Bonomo1; 1Rome/IT, 2Roma/IT
DOI:
10.1594/ecr2013/C-1667
Background
Increased international travel and immigration have seen PTB rates increase even in traditionally low burden,
industrialized settings,
with roughly a million cases estimated globally each year.
Children are particularly vulnerable to severe disease and death following infection,
and those with latent infection become the reservoir of disease reactivation in adulthood,
fueling the future epidemic [1].
For these reasons,
today PTB is considered a public health emergency.
The changing landscape in which tuberculosis occurs,
as well as the global resurgence,
and the changed spectrum of the clinical and radiological presentation,
justify a renewed interest of radiologists for the imaging features of pulmonary tuberculosis.
While intense scientific and clinical research efforts into novel diagnostic,
therapeutic and preventative interventions have focused on tuberculosis in adults,
PTB has been relatively neglected.
This is the result of challenging diagnoses which physician have to cope with in children population,
because of the rareness of clinical features (60% asymptomatic) and complexity of bacteriologic exams [Fig. 1].
In particular,
the greatest diagnostic challenge is represented by intrathoracic disease,
the most common type of PTB.
In this setting,
imaging findings associated with patient’s history are very useful to reach a final diagnosis,
to characterize the severity of disease,
to identify complications and to evaluate treatment response.
PTB has conventionally been classified as pulmonary and extrapulmonary,
without a clear correlation to the severity of disease.
Thus,
Wiseman CA et al [2] have recently proposed a new classification which may more accurately reflect the clinical disease spectrum and severity in children,
relevant to clinical management and treatment strategies.