Is it TB_?
Author: Pediatric Oncall
Question.
A 12 years old child presented with cough for 8 days with breathlessness. She was treated with Azithromycin and Salbutamol to which she responded. Her Chest X-Ray showed right sided calcified perihilar lesions and Mantoux test was positive {20 mm}. She was admitted for bilateral bronchopneumonia 2 months back and at that time Chest X-Ray showed bilateral fluffy shadows in lower zone with negative Mantoux test. At that time, she was treated with Amoxicillin-Clavulanic acid and Clarithromycin to which she responded.
Answers of this discussion
Author :- D Nagesh on 24 December 2013.
Answer :- No.observe and further tests may be conducted

Author :- ARUN CHATTERJEE on 24 December 2013.
Answer :- if ct chest andcbc suggest att may be given

Author :- Jorge Bertran M.D. on 24 December 2013.
Answer :- Quantiferon TB Gold antigen test would be usefull . If not available There is no active tb visible on xray which is not to say it is not hidden somewhere else . However this girl will go out to en endemic area ad could be exposed again . So no I would observe .

Author :- Shakil Shaikh on 25 December 2013.
Answer :- no, close followup required. monitor weight.

Author :- Muhammad Javed on 26 December 2013.
Answer :- Was he given BCG at birth. If not he should be treated for tuberculosis

Author :- drjjtambe on 30 December 2013.
Answer :- we need other parameter like current and previous wt, contact history other general finding

Author :- Saurabh Patel on 25 January 2014.
Answer :- No need of giving ATT as both times she responded to antibiotics and it is paroxysmal cough not persistent which is be present for TB.

Author :- Anil Shukla on 26 January 2014.
Answer :- In my opinion Calcified shadow with strongly positive mantoux does not equal to ATT in our country. Keen follow up required and sputtum for AFB x 3 days should be checked.

Author :- LiasMaria U P on 26 January 2014.
Answer :- no follow up the child look for acquired immuno deficiency

Author :- Catharina M.H. Wolde-Yohannes on 26 January 2014.
Answer :- Quantiferon TB Gold antigen test to confirm diagnosis

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