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Abstract
Tuberculosis continues to be a public health problem in Latin America and is one of the main causes of mortality in children. In its pulmonary form in an immunocompetent patient, typical symptoms are hemoptysis, productive cough, weight loss, fatigue, fever, and night sweats. The present case describes an atypical presentation such as spontaneous pneumothorax. This is an adolescent, with symptoms of dyspnea for 12 days without other symptoms, in whom a pneumothorax greater than 40%, fibrotic tracts in the left lung and mediastinal lymph nodes were radiologically documented. Managed with thoracostomy with pleur-evac drainage without improvement. Three smear microscopy, tuberculin skin test (PPD), Xpert MTB/RIF in sputum were negative. Xpert MTB/RIF in bronchoalveolar lavage positive for Mycobacterium tuberculosis with intermediate resistance gene to Rifampicin confirmed with Genetype. Treatment with tetraconjugate (rifampicin, isoniazid, pyrazinamide and ethambutol) was started, with good clinical evolution. Tuberculosis is a disease with variable forms of presentation in children and depends on the patient's immune status, age, location and risk factors. Pneumothorax is an unusual manifestation of this pathology to take into account within the index of diagnostic suspicion.
Key words: pulmonary tuberculosis, pneumothorax, pediatrics. Source: DeCS.