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儿童肺外结核与肺结核之间的差异:对未来的一个警示信号。

Differences between pediatric extra-pulmonary and pulmonary tuberculosis: a warning sign for the future.

作者信息

Devrim Ilker, Aktürk Hüseyin, Bayram Nuri, Apa Hurşit, Tulumoğlu Sener, Devrim Fatma, Erdem Tülin, Gulfidan Gamze, Ayhan Yüce, Tamsel Ipek, Can Demet, Alper Hüdaver

机构信息

Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

Department of Clinical Microbiology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

出版信息

Mediterr J Hematol Infect Dis. 2014 Sep 1;6(1):e2014058. doi: 10.4084/MJHID.2014.058. eCollection 2014.

Abstract

BACKGROUND

Tuberculosis (TB) remains a major global health problem. The childhood tuberculosis has some unique features different which makes the diagnosis more complicated. Here we described the epidemiologic, clinical and microbiologic features of children with extra pulmonary and pulmonary TB.

METHODS

The data of the patients <14 years with active TB were collected and compared in pulmonary (PTB) and extrapulmonary TB (EXPTB) patients.

RESULTS

A total of 128 cases was included. Forty-two cases occurred in children were < 5 years of age; 41 cases between 6-10 years and 45 cases > 10 years. PTB was present in 75,0% of the cases, and EXPTB was present in 25% of cases. There was no significant difference between the EXPTB and PTB by means of distribution of age groups (p=0,201). The rate of patients free of constitutional symptoms were significantly higher in EXPTB compared to PTB(p=0,000). There was no significant difference between EXPTB and PTB by means of sources detection(p=0,069).

CONCLUSION

TB is still a major public health problem. EXPTB has an insidious and silent onset without any constitutional symptoms, and both microbiological confirmation and the source by an adult are not frequently found. Moreover, detection of the adult source is mandatory for controlling the TB disease in children.

摘要

背景

结核病仍然是一个主要的全球健康问题。儿童结核病具有一些独特特征,这使得诊断更加复杂。在此我们描述了肺外结核和肺结核患儿的流行病学、临床和微生物学特征。

方法

收集14岁以下活动性结核病患者的数据,并在肺结核(PTB)和肺外结核(EXPTB)患者中进行比较。

结果

共纳入128例病例。42例发生在5岁以下儿童;41例在6至10岁之间,45例大于10岁。75.0%的病例为肺结核,25%的病例为肺外结核。按年龄组分布,肺外结核和肺结核之间无显著差异(p = 0.201)。与肺结核相比,肺外结核中无全身症状患者的比例显著更高(p = 0.000)。按传染源检测,肺外结核和肺结核之间无显著差异(p = 0.069)。

结论

结核病仍然是一个主要的公共卫生问题。肺外结核起病隐匿且无任何全身症状,微生物学确诊以及成人传染源均不常见。此外,检测成人传染源对于控制儿童结核病至关重要。

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