Li Ruo-Lin, Wang Jun-Li, Wang Xin-Feng, Wang Mao-Shui
Department of Medicine Research, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi People's Republic of China.
Center of Clinical Laboratory, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, Guangxi People's Republic of China.
Springerplus. 2016 Apr 27;5:546. doi: 10.1186/s40064-016-2184-7. eCollection 2016.
To describe the demographics, clinical characteristics and microbiologic findings of infant (≤2 years old) tuberculosis (TB) in a high TB burden country. Between Feb, 2007 and Jun, 2015, 115 TB infants who admitted to our hospital were enrolled in the study. Their clinicopathological characteristics were reviewed and analyzed. The mean age was 10.1 ± 7.4 (SD) months, and 84 of 115 infants (73.0 %) were males. 23 patients (20.0 %) had isolated pulmonary TB, 18 patients (15.7 %) had pulmonary and extrapulmonary TB (EPTB), the remaining 74 patients (64.4 %) had exclusively EPTB. The most common site of EPTB was lymph node (n = 61), 54 cases were left axillary lymph node involvement. 49 of 51 patients (96.1 %) were validated by pathological examination, 5 of 57 patients (8.8 %) were positive on acid fast bacilli smear, and 27 of 103 patients (26.2 %) were confirmed by mycobacterial culture. 29 of 59 patients (49.2 %) were PPD positive, 14 of 30 patients (46.7 %) were T-SPOT.TB positive. The most common complaints of patients were lymph node swelling (53.0 %), fever (36.5 %), cough (28.7 %) and dyspnea (10.4 %). There was significant difference in the time before hospital admission among different types of tuberculosis (P < 0.01), fever was also a factor influencing the time (P < 0.05). In infants, the sensitivities of routine TB tests were low and emphasize the need for improved diagnostics; EPTB was more common than pulmonary TB, tuberculous lymphadenitis constituted a high proportion of EPTB; there appears to be an association between the incidence of axillary lymph node TB and BCG vaccination among infants in China.
描述一个结核病高负担国家中婴儿(≤2岁)结核病的人口统计学特征、临床特点及微生物学检查结果。2007年2月至2015年6月期间,我院收治的115例结核病婴儿纳入本研究。回顾并分析其临床病理特征。平均年龄为10.1±7.4(标准差)个月,115例婴儿中有84例(73.0%)为男性。23例患者(20.0%)为单纯肺结核,18例患者(15.7%)为肺外结核(EPTB),其余74例患者(64.4%)为单纯EPTB。EPTB最常见的部位是淋巴结(n = 61),54例为左侧腋窝淋巴结受累。51例患者中有49例(96.1%)经病理检查确诊,57例患者中有5例(8.8%)抗酸杆菌涂片阳性,103例患者中有27例(26.2%)经分枝杆菌培养确诊。59例患者中有29例(49.2%)PPD阳性,30例患者中有14例(46.7%)T-SPOT.TB阳性。患者最常见的主诉为淋巴结肿大(53.0%)、发热(36.5%)、咳嗽(28.7%)和呼吸困难(10.4%)。不同类型结核病患者入院前时间存在显著差异(P < 0.01),发热也是影响该时间的一个因素(P < 0.05)。在婴儿中,常规结核病检查的敏感性较低,强调需要改进诊断方法;EPTB比肺结核更常见,结核性淋巴结炎在EPTB中占比很高;在中国婴儿中,腋窝淋巴结结核的发病率与卡介苗接种之间似乎存在关联。