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[Two children with extrapulmonary symptoms due to tuberculosis]
A S Slingerland1, W M van Aalderen, S de Jongh
1Emma Kinderziekenhuis AMC, afd. Kindergeneeskunde, Meibergdreef 9, 1105 AZ Amsterdam.
Insights
Diagnosing tuberculosis (TB) in children requires recognizing uncommon symptoms like red eyes or foot soles. Early detection and treatment of extrapulmonary TB are crucial to prevent disease spread and mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) can present with diverse extrapulmonary manifestations, often mimicking less severe conditions.
- Prompt diagnosis and treatment are essential for managing TB and preventing transmission.
Observation:
- A 4-year-old boy from Pakistan presented with a red eye, and a 10-year-old girl from Vietnam had red foot soles.
- Initial symptoms were minor, leading to delayed recognition of underlying tuberculosis.
Findings:
- Diagnosis was confirmed through Mantoux testing and stomach aspirate cultures.
- Both patients received appropriate multi-drug TB regimens, including isoniazid, rifampicin, pyrazinamide, and ethambutol.
Implications:
- Highlights the need for clinicians to consider extrapulmonary tuberculosis in pediatric patients, even with seemingly minor symptoms.
- Effective treatment reduces the bacterial reservoir, underscoring the importance of early diagnosis in controlling TB spread, morbidity, and mortality.
Abstract:
Two patients came to their general practitioner for relatively minor problems: a 4-year-old boy came with a red eye and a 10-year-old girl with red foot soles. They came from Pakistan and Vietnam respectively. Their symptoms were due to tuberculosis, which diagnosis was established by Mantoux test and culture of a stomach aspirate. They were treated accordingly with isoniazid, rifampicin and pyrazinamide and with isoniazid, rifampicin and ethambutol respectively. These cases stress the importance of knowledge of the extrapulmonary manifestations of tuberculosis. As treatment exists and adequate treatment can diminish the reservoir of tuberculosis bacteria, early diagnosis can prevent the morbidity, spread and mortality of tuberculosis.