Lethal fibrosing mediastinitis in a child possibly due to Mycobacterium tuberculosis.

Published on Jun 1, 2018in Pediatric Pulmonology2.534
· DOI :10.1002/PPUL.24012
Pierre Goussard16
Estimated H-index: 16
(Stellenbosch University),
Robert P. Gie38
Estimated H-index: 38
(Stellenbosch University),
Jacque Janson1
Estimated H-index: 1
(Stellenbosch University)
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Abstract
Fibrosing mediastinitis (FM) is a rare benign disease resulting from an excessive fibro-inflammatory reaction in the mediastinum that can compress and occlude mediastinal structures. There is a granulomatous and a diffuse non-granulomatous form of FM. We present a case of granulomatous FM following possible tuberculosis in a young child who presented with severe compression of the airways, pulmonary artery and the superior vena cava (SVC), unresponsive to treatment, resulting in death. Bronchoscopic findings included concentric narrowing and mucosal hyperaemia of the tracheobronchial airways. This case raises awareness of this rare complication and the limited treatment options available.
References5
Newest
#1Zhe Wu (Imperial College Healthcare)H-Index: 1
#2Hannah C. Jarvis (Imperial College London)H-Index: 4
Last. Onn Min Kon (Imperial College Healthcare)H-Index: 45
view all 5 authors...
Fibrosing mediastinitis (FM) is a rare disease where there is thickening of the fibrous tissue in the mediastinum. While histoplasmosis is the the most common recognised cause, the link with tuberculosis (TB) has been rarely documented. We review the link between TB and FM, and describe a case of probable TB-related FM.Our case is of a 74-year-old man who presented with breathlessness 3 years after fully treated TB. Scans revealed a calcified soft tissue mass within the mediastinum, and a diagno...
7 CitationsSource
#1Tobias Peikert (Mayo Clinic)H-Index: 29
#2Bijayee Shrestha (Mayo Clinic)H-Index: 3
Last. Eunhee S. Yi (Mayo Clinic)H-Index: 47
view all 9 authors...
Fibrosing mediastinitis (FM) and IgG4-related disease (IgG4-RD) are two fibroinflammatory disorders with potentially overlapping clinical and radiological features. In this paper, we looked for histopathologic features of IgG4-RD and enumerated infiltrating IgG4-positive plasma cells within mediastinal tissue biopsies from FM patients. We identified 15 consecutive FM surgical mediastinal tissue biopsies between 1985 and 2006. All patients satisfied the clinical and radiological diagnostic criter...
46 CitationsSource
#1Pierre Goussard (Stellenbosch University)H-Index: 16
#2R P Gie (Boston Children's Hospital)H-Index: 32
Last. Savvas Andronikou (UCT: University of Cape Town)H-Index: 24
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Introduction Anterior mediastinal masses in children can have different causes which includes, Mycobacterium tuberculosis (MTB) or malignant lymphadenopathy. Transbronchial needle aspiration (TBNA) has been described as a safe and effective diagnostic procedure in adult patients with lung cancer. Aim To describe the use of TBNA as a diagnostic test in children with large subcarinal lymphadenopathy and to determine the safety of the procedure in children. Patients and Methods Prospective descript...
51 CitationsSource
#1Andrew D. Sherrick (UR: University of Rochester)H-Index: 1
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Last. Jeffrey L. Myers (UR: University of Rochester)H-Index: 5
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We retrospectively reviewed the radiographic findings of fibrosing mediastinitis (FM) in 33 patients. Imaging studies included chest radiographs, computed tomographic scans, magnetic resonance imaging examinations, esophograms, ventilation perfusion scans, angiograms, and venograms. Findings include bronchial narrowing in 11 patients (33 percent), pulmonary artery obstruction/narrowing in 6 patients (18 percent), esophageal narrowing in 3 patients (9 percent), and superior vena cava obstruction/...
119 CitationsSource
#1Goodwin RaH-Index: 4
#2Nickell JaH-Index: 1
Last. Des Prez RmH-Index: 3
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Cited By1
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Two children developed fibrosing mediastinitis following past tuberculosis disease. Both were microbiologically negative for tuberculosis at presentation. One was treated with steroids and supportive therapy, but developed active tuberculosis with complications. He ultimately succumbed to healthcare-associated infection. The other recovered with steroids, administered along with antituberculosis treatment.
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