[Tuberculosis en pediatric patients in the island of Gran Canaria]

Tuberculosis is still an important sanitary problem in our country, which has a high rate of endemia. The pediatric population is highly susceptible to being exposed and has a high risk of developing the disease, as well as of suffering serious forms of it. The aim of this study was to analyze the clinical aspects and characteristics of pediatric patients who were diagnosed with tuberculosis in Gran Canaria during a nine years period.

The clinical charts of 49 children between 0 and 14 years of age who were diagnosed of having tuberculosis between 1986 and 1994 were revised. Tuberculosis was diagnosed when M. tuberculosis was isolated from at least one clinical sample.

Of the children diagnosed, 69.4% were less than 5 years of age. Only one child had antibodies against HIV. Clinical forms were; pulmonary (33 cases), disseminated (13 cases), genitourinary (1 case), osteoarticular (1 case), and lymphatic (1 case). No association was found between any clinical form and any age group. The disseminated form presented more frequently with a negative Mantoux test (p < 0.01). In all cases lung disease was present and three patients also suffered meningitis. In most of the cases (77.8%), it was necessary to wait for the result of the culture to reach the diagnosis. Two children (4.1%) died and six (12.2%) had sequeale.

Disseminated tuberculosis is relatively frequent (26.5%) in this population and is usually associated with a negative Mantoux test. Therefore, it appears that in this serious form of the disease, a high degree of clinical suspicion is needed and mycobacteria cultures must be done in clinical samples of different origins.