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[Pulmonary tuberculosis and primary infection in children. Retrospective study of 53 children]
Insights
Tuberculosis remains a concern in pediatrics, with primary infections more common than acute lung issues. Early diagnosis using tuberculin skin tests and gastric aspiration is crucial for effective treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Context:
- Tuberculosis (TB) diagnosis in children presents unique challenges.
- Retrospective analysis of pediatric TB cases in a general pediatrics department.
- Understanding the prevalence and presentation of childhood TB.
Purpose:
- To assess the frequency and clinical manifestations of tuberculosis in pediatric patients.
- To evaluate diagnostic methods including tuberculin skin tests and gastric aspiration.
- To inform therapeutic approaches for childhood tuberculosis.
Summary:
- A 4-year study of 53 children revealed TB in 1 in 250 admissions.
- Primary infections (87%) were more common than acute febrile pulmonary disease (13%).
- Mediastinal lymphadenopathy occurred in 20% of cases; tuberculin skin tests and gastric aspiration aided diagnosis.
Impact:
- Highlights the persistent burden of pediatric tuberculosis.
- Emphasizes the importance of diagnostic tools like tuberculin tests and gastric aspiration.
- Informs clinical practice for managing childhood TB effectively.
Abstract:
A 4-year retrospective study of 53 children aged from 4 1/2 months to 16 years showed the persistent frequency of tuberculosis in a general paediatrics department: one out of 250 children of the same age admitted during the same period presented with tuberculosis. Acute febrile pulmonary manifestations (13%) were much less frequent than primary infections (87%) which were symptomatic in only one out of 2 cases. But, whether the primary infection was patent or latent, mediastinal lymphadenopathy was present in one out of 5 cases. In children, a 15 mm or more intradermal reaction to 10 units of tuberculin is strongly suggestive of tuberculosis, especially when previous intradermal tests were negative. Radiography of the chest and gastric fluid aspiration indicated the degree of infection. In spite of its low yield (10% positive microscopic examinations and 20% positive cultures), gastric aspiration had the merit of confirming the diagnosis of tuberculosis in 4 out of 35 children with apparently normal X-ray films. A firm therapeutic approach could be derived from these three examinations.