Purpose or Case Report: In 2017, children under the age of 15 accounted for only 10% of the 10 million Mycobacterium tuberculosis (TB) infections estimated by the World Health Organization. Child carriers of TB pose health risks to their adult caregivers, and children can exhibit greater susceptibility to significant health risks from the infection. Nontuberculous mycobacterial (NTM) infection presents disparate health risks and can generate imaging specific findings. This presentation addresses radiologic manifestations of mycobacterial disease as a means to educate pediatric radiologists given the medical significance of mycobacterial infection.
Methods & Materials: This exhibit will discuss how children may manifest TB infections differently than adults and describe imaging findings of pulmonary and extra-thoracic TB infection in children. Contrasting findings in multi-system NTM infection will also be detailed. The presentation will provide radiologic manifestations of verified mycobacterial infection and emphasize unique characteristics of mycobacterial infection.
Results: Pulmonary TB in children may present with diffuse pulmonary disease and/or pleural effusions that can appear more impressive than the clinical presentation seemingly suggests. Extra-pulmonary TB can cause brain abscesses, osteomyelitis, and intra-abdominal infection which have distinct appearances compared to typical bacterial infections. Pathogenic NTM organisms include Mycobacterium avium-intracellulare, Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium fortuitum, and Mycobacterium chelonae. MTB commonly infect the soft tissues and cervical lymph nodes as well as the lungs. The radiologic and clinical presentation of mycobacterial infection often depends on the immune status of the child. Mycobacterial recovery is often complicated by inability to obtain a sufficient biologic specimen and lack of growth on routine contrast media. For this reason, pediatric radiologists play a key role in raising appropriate management-guiding concerns for disease.
Conclusions: Mycobacterial infection can present differently in children. Radiographic findings suggestive of pediatric TB should prompt testing in relevant contacts.