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Tuberculosis during infancy
H C Maltezou1, P Spyridis, D A Kafetzis
1University of Athens Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, Greece.
Insights
Infant tuberculosis is increasingly diagnosed, with endothoracic tuberculosis being most common. Early diagnosis and treatment of childhood tuberculosis prevent complications and reduce mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Global resurgence of tuberculosis necessitates understanding pediatric cases.
- Limited literature exists on infant tuberculosis.
- Infant tuberculosis presents unique diagnostic challenges.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of tuberculosis in infants.
- To highlight trends in infant tuberculosis diagnosis.
- To inform pediatricians about early detection strategies.
Main Methods:
- Retrospective review of infant tuberculosis cases (1982-1998) at a tertiary care hospital.
- Analysis of patient demographics, clinical presentation, diagnostic methods, and treatment outcomes.
- Inclusion criteria: infants diagnosed with tuberculosis.
Main Results:
- Thirty-nine infants (median age 10 months) diagnosed with tuberculosis.
- Endothoracic tuberculosis was the most common form (33 patients).
- Fever and cough were prevalent symptoms; chest X-rays often showed hilar adenopathy.
Conclusions:
- Infant tuberculosis diagnoses have increased, with endothoracic tuberculosis predominating.
- Contact investigation identified one-third of cases.
- Prompt diagnosis and treatment are crucial for preventing complications and mortality in infants.
Setting:
A worldwide re-emergence of tuberculosis has been observed during the last decade. However, few studies of infants with tuberculosis appear in the literature.
Objective:
To describe tuberculosis during infancy.
Design:
The records of all infants diagnosed with tuberculosis at a tertiary care hospital from 1982 to 1998 were reviewed.
Results:
Thirty-nine infants with a median age of 10 months were identified, 59% of whom presented during the second half of the study period. Diagnoses included endothoracic tuberculosis (33 patients), meningitis (3), miliary tuberculosis (2) and cervical lymphadenitis (1). Reasons for medical evaluation were the onset of symptoms (25 patients), contact investigation (12) and tuberculin skin test screening (2). Common signs and symptoms included fever (22 patients), cough (7), appetite loss (4) and wheezing/rales (4). Chest X-ray revealed hilar adenopathy (22 patients), infiltrates (16), atelectases (3) and miliary pattern (2). Cultures were attempted in nine patients and were positive in seven. All patients responded promptly to treatment. No complications or deaths occurred.
Conclusion:
Tuberculosis in infants has been diagnosed increasingly during the last decade. Endothoracic tuberculosis predominates. One third of the patients were diagnosed due to contact investigation. As early diagnosis and treatment appears to prevent complications and reduce mortality, pediatricians should be alert for tuberculosis in an infant with an atypical picture suggestive of infection.