Üç Aylık Bebekte Tüberküloz Lenfadenit

Öz

Tüberküloz lenfadenit ülkemiz gibi tüberkülozun sık görüldüğü ülkelerde çocukluk çağında akciğer dışı tüberkülozun en sık rastlanan formu olarak karşımıza çıkmaktadır. Çocuklarda sıklığının %35-67 arasında değiştiği ve en sık servikal lenf nodlarında tutulum olduğu bildirilmektedir. 3 aylık kız hasta ateş, solunum sıkıntısı ve boyunda şişlik nedeni ile çocuk servisine yatırıldı. Akut lenfadenit ön tanısıyla ampirik antibiyotik tedavisi başlandı. Ampirik antibiyotik tedavisine yanıt vermeyen hastaya yapılan TDT endürasyon çapı 18 mm ölçüldü. Aynı dönemde anne de tüberküloz tanısı aldı. Açlık mide suyunda ARB pozitif değerlendirildi. Tüberküloz PCR ile mycobacterium tuberclosis saptandı. Anti tüberküloz tedavi başlanan hasta da tedavi sonrası tam remisyon sağlanmıştır. Servikal lenfadenopati ayırıcı tanısında özellikle erken süt çocukluğu döneminde tüberküloz öncelikli olarak düşünülmeyebilir.  Sık görülen bir form olması nedeni ile lenfadenopatili hastalarda her yaşta tüberküloz düşünülmelidir.

Anahtar Kelimeler

• Lenfadenit,Süt çocuğu,Tüberküloz

Tuberculosis Lymphadenitis in a Three Month Old Baby

Öz

Tuberculosis lymphadenitis is the most common form of extrapulmonary tuberculosis in childhood in countries where tuberculosis is common. It has been reported that the incidence varies between 35-67% in children and the most common involvement is cervical lymph nodes. A 3-month-old girl was admitted to the pediatric clinic because of fever, respiratory distress and swelling on the neck.  Empirical antibiotic treatment was initiated with a preliminary diagnosis of acute lymphadenitis.  The TBT induration diameter of the patient, who did not respond to empirical antibiotic therapy, was measured 18 mm. At the same time, the mother was diagnosed with tuberculosis.  ARB positivity was found in morning gastric aspirate before meal. Mycobacterium tuberclosis was detected by tuberculosis PCR. Anti-tuberculosis treatment was initiated and complete remission was achieved after the treatment. Tuberculosis may not be considered primarily in the differential diagnosis of cervical lymphadenopathy especially in early infancy. Tuberculosis should be considered at all ages in patients with lymphadenopathy because of its prevalence.

Anahtar Kelimeler

• Infant,Lymphadenitis,Tuberculosis

Kaynakça

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