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Profile of Children With Tuberculosis in a Pediatric Intensive Care Unit in Mumbai

Soumya Renji1, Rekha Solomon2, Deepali Wankhade1

  • 1Department of Pediatrics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra.

Indian Pediatrics
|December 23, 2021
PubMed

Insights

Neurotuberculosis was the primary reason for pediatric intensive care unit admissions. Early diagnosis and drug sensitivity testing are crucial for critically ill children with tuberculosis (TB).

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Mycobacteriology

Background:

  • Tuberculosis (TB) remains a significant global health challenge, particularly in pediatric populations.
  • Critically ill children with TB often present complex clinical scenarios requiring intensive care management.
  • Understanding the profile of pediatric TB patients in intensive care settings is essential for improving outcomes.

Purpose of the Study:

  • To analyze the clinical characteristics and outcomes of confirmed pediatric tuberculosis patients admitted to a pediatric intensive care unit (PICU).
  • To identify the main indications for PICU admission in this patient group.
  • To assess the prevalence of drug resistance among pediatric TB cases in an intensive care setting.

Main Methods:

  • Retrospective analysis of bacteriologically proven pediatric TB cases admitted to a PICU between January 2007 and December 2019.
  • Data collection included patient demographics, reasons for admission, clinical findings, and microbiological results.
  • Drug resistance was classified according to World Health Organization definitions.

Main Results:

  • Fifty-nine children were included, with neurotuberculosis being the most common reason for PICU admission (31 children).
  • Severe respiratory failure and ARDS were observed in some cases.
  • Drug sensitivity testing revealed significant rates of multidrug-resistant, pre-extreme drug-resistant, and extreme drug-resistant tuberculosis.

Conclusions:

  • Neurotuberculosis is a leading cause of PICU admission for pediatric TB patients.
  • Emphasis should be placed on obtaining microbiological samples for culture and drug sensitivity testing in critically ill children with suspected or confirmed TB.
  • Improved diagnostic strategies are needed for early detection and management of drug-resistant TB in children.
Abstract

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