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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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Diagnosis of pediatric tuberculosis in the modern era

N Neu1, L Saiman, P San Gabriel

  • 1Department of Pediatrics, Columbia University, New York, NY 10032, USA.

The Pediatric Infectious Disease Journal
|February 27, 1999
PubMed

Insights

Diagnosing pediatric tuberculosis (TB) is challenging. A polymerase chain reaction (PCR) assay showed limited utility, but computerized tomography (CT) scans aided in assessing children with suspected TB.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Radiology

Background:

  • Accurate diagnosis of tuberculosis (TB) in children is crucial for effective treatment and identifying transmission sources.
  • Diagnosing TB in pediatric populations presents significant challenges.

Purpose of the Study:

  • To evaluate the effectiveness of the Amplicor polymerase chain reaction (PCR) assay for diagnosing TB in children.
  • To assess the utility of computerized tomography (CT) scans in pediatric TB diagnosis.
  • To examine the applicability of the CDC clinical case definition for TB in children.

Main Methods:

  • A study conducted at a university-affiliated pediatric hospital in New York City.
  • Evaluation of 27 children under 15 years old suspected of having TB between March 1995 and November 1997.
  • Analysis of gastric aspirate specimens using culture and PCR, alongside CT scans and chest radiographs.

Main Results:

  • Mycobacterium tuberculosis was cultured from 6.6% of gastric aspirates; PCR detected M. tuberculosis DNA in 4.1%, with poor correlation between methods.
  • CT scans were diagnostic for mediastinal or hilar adenopathy in 6 children with unclear chest radiographs and confirmed adenopathy in 8 others.
  • Alternative diagnoses were established in six children.

Conclusions:

  • Commercially available PCR technology demonstrated limited utility for detecting M. tuberculosis in pediatric gastric aspirates.
  • Computerized tomography (CT) scans proved valuable in evaluating pediatric patients with suspected TB, particularly for assessing adenopathy.
Abstract

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