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Frequency of abnormal findings on chest radiograph after positive PPD in children and adolescents in an urban setting in the United States.
Miranda-Schaeubinger, Monica; Derbew, Hermon Miliard; Ramirez, Alexandra; Smith, Maretta; Jalloul, Mohammad; Andronikou, Savvas; Otero, Hansel J.
Afiliación
  • Miranda-Schaeubinger M; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. Electronic address: mirandascm@chop.edu.
  • Derbew HM; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
  • Ramirez A; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
  • Smith M; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
  • Jalloul M; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
  • Andronikou S; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
  • Otero HJ; Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
Clin Imaging ; 105: 110024, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37989019
ABSTRACT

BACKGROUND:

Chest radiographs (CXR) for tuberculosis (TB) screening in children are valuable in high-burden settings. However, less certain in low prevalence contexts. In the United States, positive PPD is sufficient to treat for "latent" TB, or TB infection in asymptomatic patients.

OBJECTIVE:

We sought to determine frequency of abnormal CXR findings after a positive purified protein derivative (PPD) test at a tertiary pediatric center in the United States.

METHOD:

A retrospective evaluation was conducted of patients (0-18 years) with a CXR after a positive PPD (e.g., known exposure, employment, migratory requirements or before immunosuppression) between 2011 and 2021. Clinical information, demographics, and reason for PPD were recorded from health record. CXRs were evaluated using initial report and by a pediatric radiologist with special interest in TB and 8 years of experience.

RESULT:

Of 485 patients, median [interquartile range (IQR)] age 8.5[3.3-14.4], abnormal CXRs were described in 5 (1%). Most common reasons for PPD included close contact with someone with TB or with high risk for TB. Most patients 373 (76.9%) received treatment for latent TB, and 111 (22.9%) no treatment. One patient (0.2%) received treatment for active disease. Radiographic findings included isolated lymphadenopathy (n = 2), consolidation (n = 1), pleural fluid/thickening (n = 1) and a patient with lymphadenopathy and a calcified nodule (n = 1).

CONCLUSION:

In our experience, prevalence of chest radiographs findings for patients with positive PPD was very low. Moreover, no cases of severe disease were seen and those with abnormal findings would not merit treatment change under current WHO guidelines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Pulmonar / Linfadenopatía Límite: Adolescent / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Pulmonar / Linfadenopatía Límite: Adolescent / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos