儿科结核病的临床特征：一家三级护理中心的微生物学相关性研究。
Clinical Spectrum of Pediatric Tuberculosis: A Microbiological Correlation from a Tertiary Care Center.
机构信息
Department of microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi, India.
Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi, India.
出版信息
J Trop Pediatr. 2019 Apr 1;65(2):130-138. doi: 10.1093/tropej/fmy026.
AIM AND OBJECTIVES
The paucibacillary nature of pediatric tuberculosis (TB) makes diagnosis difficult. The aim of the study was to correlate the clinical spectrum of pediatric TB with microbiological diagnosis.
MATERIALS AND METHODS
Specimens from clinically suspected pediatric TB cases were subjected to Ziehl-Neelsen staining, culture on Lowenstein-Jensen medium and cartridge-based nucleic acid amplification test (CB-NAAT) for TB.
RESULTS
Pulmonary TB was the predominant form affecting 36 of 62 (58%) patients. Tubercular meningitis was the commonest form of extrapulmonary type and affected 13 of 26 (50%) children. Microbiological diagnosis by any of the above methods could be established in 35 (56.45%) cases. While 33 of 36 (92%) patients diagnosed with pulmonary TB had radiological findings, of which only 25 (76%) could be microbiologically confirmed, only 24 of 31 (77%) patients with extrapulmonary symptoms had radiological evidence and microbiological confirmation could be achieved in 4 (17%) of these.
CONCLUSION
An integrated approach of diagnosis, including clinical-radiological, microbiological and immunological evidence should be stressed on.
目的和目标
小儿结核病（TB）的少菌性使得诊断变得困难。本研究的目的是将小儿 TB 的临床谱与微生物学诊断相关联。
材料和方法
对临床疑似小儿 TB 病例的标本进行抗酸染色、Lowenstein-Jensen 培养基培养和基于试剂盒的核酸扩增试验（CB-NAAT）检测 TB。
结果
肺结核是最主要的形式，影响了 62 例中的 36 例（58%）。结核性脑膜炎是最常见的肺外类型，影响了 26 例中的 13 例（50%）儿童。通过上述任何一种方法都可以在 35 例（56.45%）病例中建立微生物学诊断。虽然 36 例被诊断为肺结核的患者中有 33 例（92%）有放射学发现，但其中只有 25 例（76%）可以得到微生物学证实，31 例有肺外症状的患者中只有 24 例（77%）有放射学证据，而这些患者中只有 4 例（17%）可以得到微生物学证实。
结论
应强调综合诊断方法，包括临床-放射学、微生物学和免疫学证据。
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