Purpose or Case Report: Although Tuberculosis (TB) is very common in early childhood, we see an increased incidence of TB in adolescents due to increased susceptibility. It is also important to note that adolescent TB affects those living in low/middle income countries where TB is very common. There is a paucity of literature regarding the sequelae of TB disease in adolescents based on advanced cross-sectional imaging. We aimed to review the imaging features seen on CT imaging of the chest post adolescent TB in a cohort of patients from Peru.
Methods & Materials: Retrospective review of CT scans of patients with tuberculosis was performed between 2021 and 2023. An experienced pediatric radiologist (>20 years of experience) reviewed the CT scans of the chest for different sequelae post TB disease.
Results: We reviewed CT scans in 24 patients, 13 males and 11 females, (mean age at CT scan of 19.1 (SD:1.7) years and mean age at the time of TB diagnosis of 17.2 (SD: 1.6) years). Of the 24, 18 (75%) were confirmed microscopically. All CT scans were deemed of good quality, and all included intravenous contrast. 23/24 (95.8%) had parenchymal disease and only 1 (4.2%) was normal. The commonest findings were architectural distortion 23/24 (95.8%) and reticular pattern 18/24 (75%). The architectural distortion was seen predominantly in the left upper lobe (LUL) (14) and right upper lobe (RUL) (9) but was also noted in the right middle lobe (RML) (3), right lower lobe (RLL) (3) and left lower lobe (LLL) (5). Other common findings included: bronchiectasis in 14/24 [58.3%] – [8 RUL, 8 LUL, 4 LLL, 3 RLL AND 1 RML] and nodules [13 (54.2%)] which were mainly scattered and often in multiple lobes. Cavities were not as common and seen in 5/24 (20.8%) [4 in RUL and 1 in LUL]. Lymphadenopathy seen in only 3/24 and all three had some calcified nodes.
Conclusions: Delayed CT of the chest in almost all patients who had TB as adolescents showed destructive sequelae and complications, well described in adult tuberculosis. There were 14 cases with features that may represent active disease such as nodules, lymphadenopathy, or both.