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Case Reports
April 1937


Author Affiliations

From the Department of Pediatrics, Stanford University School of Medicine, San Francisco, and Arequipa Sanatorium, Manor, Calif.

Am J Dis Child. 1937;53(4):1047-1052. doi:10.1001/archpedi.1937.04140110117012

The differential diagnosis between pulmonary tuberculosis and bronchiectasis is a frequent problem when dealing with adult patients. Basilar lesions of a chronic infectious nature are seen less frequently in children but often enough so that the determination of their nature is important. Because of the often quoted adage, "Apical lesions should be considered tuberculous until proved otherwise and basilar lesions should be considered nontuberculous until proved otherwise," the fact may be lost sight of that both bronchiectasis and tuberculosis may be present in the same patient in the same localized pulmonic area. That tuberculosis may be a cause of localized bronchiectasis through changes in the bronchi by prolonged tuberculous ulceration has, of course, been recognized for a long time; and Wallgren1 has reported bronchiectasis in children following healed primary epituberculous complexes, in which the sputum gives no evidence of tuberculous infection or is absent. In proof of the fact

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