Abstract:

The chest imaging findings, lesions location, and bronchoscopy manifestations were retrospectively analyzed of 19 children with bronchial tuberculosis from January 2010 to December 2016 in Department of Tuberculosis, Nanjing Chest Hospital. All of the children were misdiagnosed before admission. The misdiagnosis was also summarized. Among the 19 cases, 10 cases showed a large high-density shadow in pulmonary on chest CT, and 9 cases showed spot patchy shadow. Performances under bronchoscope indicated 8 cases with ulcers necrosis, 6 cases with inflammation infiltration, 3 cases with scar type, and 2 cases with proliferative granulation. According to bronchoscopy for the most serious region, there were 10 cases with bronchial tuberculosis lesions located in the upper lobe, 4 cases in the basal segment of the lower, 3 cases in the dorsal segmental, and 2 cases in the left main bronchus. The main symptom of 17 cases was chronic cough, and 11 cases had complaint of chest tightness and discomfort. Due to these atypical symptoms, 19 children were misdiagnosed as bronchitis (n=7), cough allergic asthma (n=4), mycoplasma pneumonia (n=3), bronchial asthma (n=2), upper airway cough syndrome (n=2) or cough after infection (n=1) before admitted to our hospital. We conclude that the clinical characteristics of bronchial tuberculosis in children are lack of specificity, and can easily be misdiagnosed in clinical. Thus, we need to be more cautious in order to diagnose bronchial tuberculosis by timely using bronchoscopy.

Key words: Bronchial diseases, Tuberculosis, Child, Disease attributes, Diagnostic errors