Children's medicine of the North-West

Differential diagnosis of tuberculosis relapse and nonspecific pneumonia: a case of prolonged follow-up

  • Ksenia P. Yulina Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation https://orcid.org/0009-0004-5503-4002
  • Marina E. Lozovskaya Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation
  • Karina A. Papayan Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation https://orcid.org/0000-0001-8692-0315
  • Alexandra O. Ivanova Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation https://orcid.org/0009-0001-6822-2270
  • Dmitry S. Kashin Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation https://orcid.org/0009-0004-0126-4654
  • Yulia A. Yarovaya Saint Petersburg State Pediatric Medical University, 2 Lithuania, Saint Petersburg 194100, Russian Federation https://orcid.org/0000-0001-8700-9267
Keywords:
дети туберкулез внутригрудных лимфоузлов полисегментарная пневмония рецидив туберкулеза children intrathoracic lymph node tuberculosis polysegmental pneumonia tuberculosis relapse

Abstract

The differential diagnosis of pulmonary tuberculosis and prolonged pneumonia in children presents significant challenges. It is particularly complex in cases where a child has previously had primary tuberculosis and exhibits residual post-tuberculosis changes in the lungs and intrathoracic lymph nodes. Such patients are at risk of tuberculosis relapse. This article presents a follow-up case of a child with a long history of tuberculosis. At the age of 6, the girl had a complicated form of primary tuberculosis, which was successfully treated but left residual changes in the intrathoracic lymph nodes and lungs. At the age of 13, she developed a pulmonary condition highly suggestive of tuberculosis, raising suspicion of relapse. However, comprehensive examination, treatment, and dynamic follow-up led to a diagnosis of community-acquired polysegmental pneumonia against the background of residual post-tuberculosis changes, including calcifications in the lung tissue and intrathoracic lymph nodes. Key diagnostic methods included a recombinant tuberculosis allergen test, chest computed tomography, fiberoptic bronchoscopy, and bacteriological examination.

References

Горбач Л.А. Рецидивы туберкулеза органов дыхания у детей. Современные перинатальные медицинские технологии в решении проблем демографической безопасности. 2019;12:209–213. EDN: UKEMLX.

Аксенова В.А., Барышникова Л.А., Севостьянова Т.А., Клевно Н.И. Туберкулез у детей в России и задачи фтизиатрической и общей педиатрической службы по профилактике и раннему выявлению заболевания. Туберкулез и болезни легких. 2014;3:40–46. DOI: 10.21292/2075-1230-2014-0-3-64-73.

Король О.И., Лозовская М.Э. Туберкулез у детей и подростков. СПб.: СпецЛит; 2005.

Бармина Н.А., Голубь Н.В. Факторы риска фор­мирования рецидивов туберкулеза у детей в современных условиях. Врач. 2023;34(6): 55–58. DOI: 10.29296/25877305-2023-06-11.

Бармина Н.А., Корнеев Ю.В. Возможные причины формирования рецидивов туберкулеза у детей в современных условиях: клинические наблюдения. Педиатрия им. Г.Н. Сперанского. 2021;100(3):187–192. DOI: 10.24110/0031-403X-2021-100-3-187-192.

Лозовская М.Э., Яровая Ю.А., Васильева Е.Б., Клочкова Л.В., Степанов Г.А., Мидаева Л.Н., Куро­ва А.С. Фтизиатрия детского возраста. М.; 2024.

Клинические рекомендации «Туберкулез у детей» МЗ РФ. 2022-2023-2024. Доступно по: https://minzdrav.krasnodar.ru/documents/informatsionno-metodicheskie-materialy/klinicheskie-rekomendatsii-protokoly-lecheniya-po-profilyu-pediatriya/367488 (дата обращения: 18.07.2025).

Сводное руководство ВОЗ по туберкулезу. Модуль 5. Ведение туберкулеза у детей и подростков. Всемирная организация здравоохранения; 2023. Доступно по: https://iris.who.int/bitstream/handle/10665/366383/9789289058698-rus.pdf (дата обращения: 19.07.2025).

Vega V., Cabrera-Sanchez J., Rodríguez Sh., Verdonck K., Seas C., Otero L., Van der Stuyft P. Risk factors for pulmonary tuberculosis recurrence, relapse and reinfection: a systematic review and meta-analysis. BMJ Open Respir Res. 2024;11(1): e002281. DOI: 10.1136/bmjresp-2023-002281.

Tiberi S., du Plessis N., Walzl G., Vjecha M.J., Rao M., Ntoumi F., Mfinanga S., Kapata N., Mwaba P., McHugh T.D., Ippolito G., Migliori G.B., Maeurer M.J., Zumla A. Tuber­culosis: progress and advances in development of new drugs, treatment regimens, and host-directed therapies. Lancet Infect Dis. 2018;18(7):e183–e198. DOI: 10.1016/S1473-3099(18)30110-5.

How to Cite
Differential diagnosis of tuberculosis relapse and nonspecific pneumonia: a case of prolonged follow-up. (2025). Children’s Medicine of the North-West, 13(3), 212-222. https://doi.org/10.56871/CmN-W.2025.94.82.020
Issue
Vol. 13 No. 3 (2025)
Section
Practical notes
Published
2025-11-22

How to Cite

Differential diagnosis of tuberculosis relapse and nonspecific pneumonia: a case of prolonged follow-up. (2025). Children’s Medicine of the North-West, 13(3), 212-222. https://doi.org/10.56871/CmN-W.2025.94.82.020