Lobar Pneumonia with Bronchial Narrowing: A Typical Sign of Primary Tuberculosis in Children

Purpose of Review Community-acquired pneumonia is most prevalent in children with less than 5 years of age, and this age group is also at the highest risk for pulmonary tuberculosis. Objective Our objective is to describe bronchial narrowing in chest X-rays, with patients with image of pneumonia, as a typical radiographic sign of primary tuberculosis in children. Materials and Methods Chest radiographic findings of nine patients (five boys and four girls; age range 9–30 months; mean age 17.6 months) treated for community-acquired pneumonia with no clinical improvement were studied retrospectively. Recent Finding Chest radiographs, in all cases, showed lobar pneumonia with bronchial narrowing. Bronchial narrowing was found either in the main right or left bronchi and was ipsilateral to the lobar consolidation in all cases. Positive tests or epidemiology for tuberculosis was obtained, and patient was treated for tuberculosis with improvement. At the end of treatment, follow-up radiographs were normal, including resolution of bronchial narrowing. Summary In the setting of community-acquired pneumonia in children under 3 years of age with no clinical improvement after empiric treatment, a chest radiograph showing bronchial narrowing should raise suspicion for a tuberculosis etiology and elicit change to both diagnostic and therapeutic management.