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Bacteriologically confirmed pulmonary tuberculosis in childhood. Clinical and radiological features
Insights
Pediatric tuberculosis (TB) is common in young children, particularly boys. Diagnosis can be challenging, with many presenting with negative tuberculin tests and common radiographic findings like lymphadenopathy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pulmonary tuberculosis (TB) remains a significant global health concern, particularly in pediatric populations.
- Diagnosis of TB in children can be complex due to varied clinical presentations and limitations of diagnostic tests.
Purpose of the Study:
- To describe the epidemiological and clinical characteristics of pediatric pulmonary tuberculosis.
- To highlight common diagnostic challenges and radiographic findings in children with TB.
Main Methods:
- Retrospective analysis of 185 confirmed pediatric pulmonary tuberculosis cases over a 4-year period.
- Data collection included patient demographics, diagnostic methods (Mycobacterium tuberculosis culture from gastric aspirate), tuberculin test results, and chest radiography findings.
Main Results:
- The majority of cases (62%) occurred in boys, with a high prevalence in younger age groups (26% <1 year, 65% <3 years).
- A significant proportion (40%) of tested children had negative tuberculin tests at presentation.
- Common radiographic findings included lymphadenopathy (63%) and segmental lesions (56%), predominantly in the right lung. Cavitating disease was observed in 19 children.
Conclusions:
- Pediatric pulmonary tuberculosis disproportionately affects young boys and infants.
- Diagnostic approaches should consider the possibility of TB even with negative tuberculin tests.
- Radiographic findings like lymphadenopathy and segmental lesions are key indicators in diagnosing childhood TB.
Abstract:
Over a 4-year period 185 cases of pulmonary tuberculosis in children were confirmed by culture of Mycobacterium tuberculosis, usually from gastric aspirate. The majority of cases occurred in boys (62%) and the younger age groups were more commonly affected--26% of patients were less than 1 year old and 65% less than 3 years of age. At the time of presentation 40% of the 151 children tested had a negative tuberculin test. A chest radiograph was available in 136 cases. The commonest changes seen were lymphadenopathy (63%) and segmental lesions (56%). The latter affected mainly the right lung and in particular the right middle lobe. Cavitating tuberculous disease was present in 19 children, including 5 aged less than 1 year.