Pediatric emergency medicine trisk 2385 2385

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Clinical findings

Radiographic and other
findings

Pulmonary

Fever, cough, weight loss;
hemoptysis and night
sweats are rare in young
children

The most common CXR
findings are hilar or
mediastinal adenopathy,
parenchymal
consolidations, freeflowing pleural
effusions; cavitary
lesions are rare in young
children. TSTs are
positive in most, but can
be anergic in
overwhelming TB
disease.
AFB cultures positive in
20–40%

Peripheral
Painless enlargement (2–4 CXR abnormal in up to

lymphadenopathy
cm) of anterior, posterior
33%.
cervical, submandibular, TSTs positive in most.
or supraclavicular nodes AFB cultures positive in
with no signs of
75%.
inflammation. Fever or
other constitutional
symptoms seen in 50–
60%
Meningeal

Three well-described
CXR abnormal in up to
stages:
90%.
I: Headache, fever,
CT brain findings can
constitutional symptoms
include hydrocephalus,
leptomeningeal
II: Cranial nerve palsies,
enhancement,
meningismus, some
tuberculomas, and
alterations in mental
vascular infarcts.
status
III: Obtunded or comatose CSF findings: lymphocytic

pleocytosis with high