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RADIOLOGY: LUNG: Case# 33633: PRIMARY TUBERCULOUS. Three year old with cough and fever. Chest x-ray reveals right upper lobe consolidation with scattered air bronchograms. There is hilar fullness bilaterally and in the right paratracheal region. No pleural effusion is identified. Approximately 1100 children present with active tuberculous disease in the United States annually. The number of cases appears to be rising, possibly because of the increase in the number of cases of AIDS. The findings of adenopathy with a lobar consolidation in a child are compatible with tuberculosis until proven otherwise. Other entities in this differential include mycoplasma pneumonia, leukemia/ lymphoma, histoplasmosis or coccidioidomycosis. A pleural effusion can be seen in primary TB although it is not identified in this case.

Peter Anderson
lung, radiology