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Extrapulmonary tuberculosis in children
E D McIntosh1, D Isaacs, R K Oates
1Department of Immunology and Infectious Disease, Royal Alexandria Hospital for Children, Camperdown, NSW.
Insights
An apparent increase in pediatric extrapulmonary tuberculosis (TB) admissions was not statistically significant. Immigration and contact with infected adults are key factors in childhood TB cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Extrapulmonary tuberculosis (TB) presents diagnostic challenges in children.
- Identifying risk factors for childhood TB is crucial for early intervention.
Objective:
To investigate an apparent increase in the number of children admitted to the Royal Alexandra Hospital for Children with extrapulmonary tuberculosis (TB). Further, to highlight both the seriousness of this disease and the difficulty of its diagnosis, and to draw attention to factors such as ethnic origin in identifying children at risk.
Design:
Clinical and microbiological data were collected for all children admitted to the hospital with a confirmed diagnosis of TB. A standardised incidence ratio (SIR) was used to analyse the number of children admitted with extrapulmonary TB in 1990-1991 compared with 1982-1989, and in 1987-1991 compared with 1982-1986.
Results:
Eleven children (five of these in 1990 and 1991) had extrapulmonary TB (4, central nervous system; 3, osteomyelitis; 2, cervical lymphadenitis; 2, abdominal). One was Aboriginal and 10 were from families of overseas origin. Twenty-one others had pulmonary TB and 17 of these were from families of overseas origin. The apparent increase in the number of admissions for extrapulmonary TB was not statistically significant.
Conclusion:
There has been a recent increase in the number of children hospitalised with extrapulmonary TB but when this is compared with the increase in children hospitalised for all causes, the increase is not significant. Immigration and the continuing contact of children with infected adults appear to account for most cases of TB in this series.