[The risk of grave evolution of tuberculosis in young children (under 2 years of age)]

Between 1971 and 1972, 22% of all children under two years with tuberculosis presented with severe forms of the disease (meningitis, miliaria, caseous forms). In the period 1974-1975, although the number of cases in the group was reduced by half, the severe forms still represented 20,4% of the total. The risk of severe evolution of tuberculosis decreases rapidly, from 55--66% in the first months of life. to 14,2--15,5% at 1--2 years. The risk of death in children aged between 0 and 2 years with tuberculosis (all forms) was of 26,6--58,3% between 0 and 5 months but only 4,5--9,3% in the second year of life. The risk of death in young children with severe forms of tuberculosis was as high as 70--76,7% in those under the age of 6 months. The source of infection was identified in 72,4--76,4% of the severe cases. At the onset of the disease only 57,1% of the sources were known, while 42,9% were discovered later, by epidemiologic investigations. An analysis of cause for a severe evolution of tuberculosis in young children led to the conclusion that BCG vaccination should be performed systematically at birth, and that tuberculin skin test be carried out in all hospitalized children, regardless the diagnosis. They also recommend the use of anamnestic data concerning the possible existence of tuberculosis cases in the families of patients, performing of radiologic controls in young mothers etc. In the case of infants that come into a close contact at a very early age with parents, or other relatives suffering with tuberculosis, chemoprophylaxis with two associated tuberculostatics is indicated.