Ciambarella医生问:我在门诊中遇到1名5岁儿童,他2岁时与父母一起住在印度尼西亚。当时由于他家的花匠被诊断为活动性肺结核,所以对他接种了BCG。虽然该儿童与花匠接触不多,但他与花匠的2岁儿子每天接触。在接种BCG前,两名儿童结核菌素皮肤试验均为阴性。根据病史和体格检查,该儿童目前健康,没有理由怀疑他罹患结核病。鉴于3年前他有可能接触过肺结核病人,所以有理由对他拍摄胸部X片以检查结核病吗?应该对 Dr. Ciambarella asks: I met a 5-year-old in the clinic and he lived with his parents in Indonesia when he was 2 years old. He was vaccinated with BCG because his gardener was diagnosed with active tuberculosis. Although the child had little contact with the gardener, he was in daily contact with the gardener’s 2-year-old son. Both children had a negative tuberculin skin test before BCG vaccination. According to medical history and physical examination, the child is currently healthy and there is no reason to suspect that he is suffering from tuberculosis. Given that he may have had contact with TB patients three years ago, it is reasonable to photograph him with a chest X-ray to check for tuberculosis.