Chronic Tuberculous Hilus Pneumonia in Children

No disease has received more attention in the literature than tuberculosis, especially pulmonary tuberculosis, yet the subject is by no means exhausted.There is a type of pulmonary tuberculosis infrequently met with in children which is often overlooked, unless constantly kept in mind.The most frequent form of tuberculosis in children, aside from tuberculous meningitis and miliary tuberculosis, is tuberculous pneu- monia, either of the lobar pneumonic or bronchopneumonic type.Chronic tuberculosis as met with in adults is almost unknown in infants and children under 2 years of age.With the aid of the roentgen ray more cases of the chronic and subacute forms are being discovered.(Reuben,1 Dunn,2 Eisler,3 and Wesler and Bass,4 speak of such cases.)The type of tuberculosis to which I wish to call attention may be defined as a diffuse or parenchymatous process involving that portion of the lung immediately adjacent to the hilus.It is characterized by a gradual onset, comparatively mild constitutional symptoms, fairly definite physical signs (except early), and, as a rule, ends in recovery.The mode of entry, as in most other forms of pulmonary tuber¬ culosis, is probably through the respiratory tract, according to the views of Hamburger,5 Ghon6 and Dunn2 in this country.This point is by no means definitely settled.The pathology is not definitely known.There are no necropsy reports and we only know the roentgen-ray and clinical findings, as determined by physical examination.Early roentgenologic studies reveal considerable enlargement of the tracheobronchial glands.This