Cavitary Pulmonary Tuberculosis in an Infant

Tuberculosis (TB) continues to pose a significant health challenge globally and in Portugal. Diagnostic challenges persist, especially in infants, where TB often presents with atypical symptoms. A previously healthy three-month-old male infant from Vila Nova de Famalicão, Portugal, was admitted with cough, rhinorrhea, respiratory distress, and high-grade fever. After chest radiography and blood tests, he was treated with ampicillin for community-acquired pneumonia (CAP). Initial antibiotic therapy proved ineffective, and subsequent imaging showed necrotizing pneumonia. Thoracic computed tomography and bronchoscopy revealed a significant consolidation with cavitation and lymphatic involvement, as well as extrinsic compression of the right main bronchus. Gastric aspirates (GA) and bronchoalveolar lavage (BAL) washings grew <i>Mycobacterium tuberculosis</i>. Treatment eventually with antituberculosis drugs and prednisolone resulted in clinical and radiological improvement. Subsequent immunological evaluations were normal.