ABSTRACT
PURPOSE: Many articles have been published regarding chest-imaging in COVID-19, but fewer studies have been published in pediatric populations. COVID-19 symptoms in children are generally milder and radiological tests have fewer positive findings. Indications for chest imaging in pediatric COVID-19 patients remain unclear. This study aims to describe the chest radiographs performed in COVID-19 patients in a pediatric hospital, to review the current chest X-ray indications and to develop an specific age-adjusted protocol for chest-imaging in children with COVID-19. METHODS: Retrospective study in hospitalized pediatric COVID-19 patients in Navarre, Spain. Between March and December 2020, 44 children were included (mean age 3.8-year-old, 50 % males). Demographic information, cause of admission, symptoms, and clinical evolution were described. Chest imaging technique performed, indications and findings were analyzed. A literature review was performed searching for current COVID-19 pediatric chest-imaging indications. RESULTS: Chest X-rays were performed in 35 patients (80 % of admissions) and most common indications were fever and respiratory symptoms. 53 % of the chest X-rays were considered "normal" and the classical bilateral diffuse interstitial pattern, described in adults, was only present in 22 %. All patients with pathological chest X-rays were symptomatic and reported fever (100 %) and fever tended to be longer (fever duration: 4.25 vs. 2.46 days p:0.048) in patients with pathological radiographs. We present a specific protocol for chest-imaging in pediatric COVID-19 cases. CONCLUSIONS: COVID-19 clinical manifestations and radiological findings are milder and less specific in children. Imaging should not be used as a screening tool or a routine complementary test in pediatric COVID-19 patients, not even in hospitalized cases.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Infant , Child, Preschool , Lung Injury/diagnostic imaging , Respiratory Tract Infections/etiology , Prognosis , Lung Neoplasms/diagnostic imaging , Radiography, Thoracic/methods , Lung Injury/pathology , Lung Neoplasms/surgery , Solitary Fibrous Tumors/surgerySubject(s)
Cystic Adenomatoid Malformation of Lung, Congenital/complications , Cysts/complications , Lung Diseases/complications , Pneumonia/complications , Causality , Child, Preschool , Cystic Adenomatoid Malformation of Lung, Congenital/diagnosis , Cystic Adenomatoid Malformation of Lung, Congenital/diagnostic imaging , Cystic Adenomatoid Malformation of Lung, Congenital/surgery , Cysts/diagnostic imaging , Cysts/surgery , Diagnosis, Differential , Disease Susceptibility , Humans , Infant , Lung Diseases/diagnostic imaging , Lung Diseases/surgery , Male , Tomography, X-Ray ComputedABSTRACT
La afectación ganglionar por Mycobacterium tuberculosis puede ocurrir tras una diseminación linfohemática a partir de una afectación primaria pulmonar, o por primoinfección extrapulmonar, cuya puerta de entrada son las mucosas o contacto con objetos contaminados. Se presenta el caso de un niño de diez años, nacido en España, afecto de adenitis tuberculosa en la región inguinal, cuya infección se produjo tras una herida en el pie ocurrida en una playa de Brasil. Tras el inicio de la terapia antituberculosa desarrolló una escrófula que requirió desbridamiento quirúrgico, con buena evolución posterior (AU)
Tuberculous lymphadenitis can be caused either by an haematogenous spread from a pulmonary primary form or by an extrapulmonary infection due to cutaneous lesions or contact with contaminated items. We present a 10-year-old spanish boy, who has an inguinal tuberculous lymphadenitis. Infection was secondary to a foot injury caused in a Brazilian beach. A scrofula appeared after triple therapy was instaured, needing surgical debridement with a favourable clinical evolution (AU)
