diagnostic value of bronchoscopy in children with intrathoracic tuberculous lymphadenopathy

Tuberculous involvement of the hilar or the paratracheal lymph nodes may compress trachea or bronchi more often in children. The aim of this study is to report the bronchoscopic features and the diagnostic value of fiberoptic bronchoscope in infants and children presented with isolated tuberculous mediastinal lymphadenopathy. Twenty infants and children [12 girls and 8 boys] ranging in age between 2 and 10 years were studied. All children were subjected to detailed family history of tuberculosis [positive in 40% of cases], complete clinical examination with special emphasis on growth charts [difficulty gaining weight in 50% of cases] and lymph node examination. Mantoux tuberculin skin test [5-TU of PPD] and chest radiography were done to all children. All cases were bronchoscoped using the pediatric fiberoptic bronchoscope, Olympus BF[3]C[30] under general anesthesia. Eighteen patients [90%] had endobronchial abnormalities and the diagnosis of tuberculosis was confirmed in 60% of cases by bronchial biopsies and lavage. From this study, it is concluded that fiberoptic bronchoscopy has a significant diagnostic value in infants and children with tuberculous mediastinal lymphadenopathy and may avoid more invasive procedures