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Extra-pulmonary tuberculosis in children
H C Maltezou1, P Spyridis, D A Kafetzis
1University of Athens Second Department of Pediatrics, P & A Kyriakou Children's Hospital, Athens, 11527, Greece.
Insights
Extra-pulmonary tuberculosis in children increased by 50% over a decade. While no deaths occurred, meningitis cases experienced delayed treatment and permanent neurological deficits, often linked to socioeconomic factors.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Extra-pulmonary tuberculosis (EPTB) presents unique challenges in pediatric populations.
- Understanding the clinical and epidemiological trends of EPTB is crucial for effective public health strategies.
Purpose of the Study:
- To review the clinical and epidemiological features of pediatric extra-pulmonary tuberculosis.
- To identify trends and risk factors associated with EPTB in children.
Main Methods:
- Retrospective review of 102 children diagnosed with EPTB between 1982 and 1998.
- Analysis of patient demographics, clinical presentations, diagnoses, and treatment outcomes.
Main Results:
- A 50% increase in pediatric EPTB admissions was observed over the decade.
- Common diagnoses included lymphadenitis, pleural effusion, and meningitis, with age-specific patterns.
- Delayed treatment in meningitis cases correlated with permanent neurological deficits, particularly in patients from disadvantaged backgrounds.
Conclusions:
- EPTB affects children across various age groups, with distinct manifestations.
- Prompt diagnosis and treatment are vital, especially for pediatric meningitis, to prevent long-term sequelae.
- Socioeconomic factors like poverty and limited healthcare access are significant risk factors for severe EPTB outcomes.
Methods:
The clinical and epidemiological features of 102 children with extra-pulmonary tuberculosis, diagnosed between 1982 and 1998 at P & A Kyriakou Children's Hospital were reviewed.
Results:
During the past decade, a 50% increase of admissions for extra-pulmonary tuberculosis was observed. The source of infection was disclosed in 48 patients. Diagnoses included superficial lymphadenitis (n = 48), pleural effusion (n = 27), meningitis (n = 16), skeletal tuberculosis (n = 5), miliary tuberculosis (n = 3), abdominal tuberculosis (n = 2), and pericarditis (n = 1). Miliary tuberculosis developed in infants, lymphadenitis and meningitis in preschool children, and pleural effusion and skeletal tuberculosis in older children. None of the patients with extra-pulmonary tuberculosis died; however, six patients with meningitis developed permanent neurological deficits. In these patients, antituberculous treatment was introduced at a median of six days following admission as compared with one day in patients with no complications. Poverty, immigration, and limited access to medical services were common among patients with meningitis.