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[Thirty-five cases of tuberculosis in childhood]
Insights
Childhood tuberculosis, particularly hematogenous spread types like meningeal and military tuberculosis, remains a concern. Early diagnosis and awareness are crucial for improving outcomes in pediatric TB cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Context:
- Tuberculosis (TB) incidence in children has been declining.
- However, severe forms of childhood TB persist, posing significant challenges.
- This review examines pediatric TB cases admitted to a tertiary care hospital over a 15-year period.
Purpose:
- To analyze the clinical characteristics, types, and epidemiological features of childhood tuberculosis.
- To identify risk factors and transmission patterns in pediatric TB patients.
- To highlight the importance of recognizing and managing severe childhood TB.
Summary:
- A review of 35 children with tuberculosis revealed diverse forms including meningeal, military, primary, and adult-type pulmonary TB.
- Younger children (<2 years) predominantly presented with hematogenous spread TB (meningeal, military).
- A high proportion lacked BCG vaccination, and household adult-to-child transmission was common, often identified post-diagnosis.
Impact:
- Despite declining incidence, severe childhood TB with poor prognosis continues to occur.
- Findings underscore the need for vigilance in outpatient settings for early detection.
- This research emphasizes the ongoing relevance of childhood tuberculosis management and prevention strategies.
Abstract:
Thirty five children with tuberculosis admitted to the Hokkaido University Hospital from 1970 through 1984 wer reviewed. They were 7 cases of meningeal tuberculosis, 8 of military tuberculosis, 15 of primary tuberculosis and 5 of adult type pulmonary tuberculosis. Fifteen (43%) of the 35 cases were below 2 years, and over half of these younger cases were hematogenous spread such as meningeal and military types. Instead of hematogenic spread in these cases, erythrocyte sedimentation rate and CRP stayed in moderate values. Thirty one (91.2%) of the 34 cases having precise record had no history of BCG inoculation. Over half of the cases were infected from adults in the immediate household, and the sources of infection were found after the diagnosis of childhood tuberculosis in about half of these cases. Although incidence of the childhood tuberculosis are decreasing in recent years, childhood tuberculosis resulting hematogenous spread with poor prognosis in advanced state still exists, so it is important to remark the childhood tuberculosis at out patient clinics.