Ten-year experience of children with tuberculosis in southern Taiwan

Data on the clinical characteristics of pediatric tuberculosis (TB) are limited. This retrospective study was performed to evaluate the demographic characteristics and clinical features of pediatric TB.

The medical records of children with TB at Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, between 1992 and 2002 were analyzed for demographic and clinical characteristics, and treatment regimens.

103 children aged 0 to 14 years with probable or confirmed TB were enrolled. Ninety patients (87.4%) had pulmonary tuberculosis (PTB) and 13 (12.6%) had extrapulmonary tuberculosis (EPTB). The mean +/- standard deviation age of children with PTB and with EPTB was 6.0 +/- 4.2 years and 4.5 +/- 5.4 years, respectively. Household contact was the route of infection for 44.4% of patients with PTB and 7.7% of patients with EPTB. TB in children aged 0 to 4 years most commonly involved the lung (53.3%) or the extrapulmonary region (69.2%). Common symptoms of PTB were cough (81.1%) and fever (33.3%). The most frequent sites of pediatric EPTB were bone (n = 4) and cervical lymph nodes (n = 4). Tuberculin skin test (TST; >or=10 mm) was positive in 69.6% of children with PTB (55/79) and 37.5% of children with EPTB (3/8). Children with PTB had a lower positive acidfast bacilli rate (40.0%) and Mycobacterium tuberculosis culture (27.8%). Eighty percent of patients infected through household contact had a positive TST.

Prolonged cough, household TB contact, and positive TST were characteristic factors for children with PTB in southern Taiwan. Young age was associated with high morbidity.