儿童结核病的管理。

Management of Children with Tuberculosis.

机构信息

The Children's Hospital at Westmead Clinical School, Level 3 Children's Hospital Westmead, Locked Bag 4001, Hawkesbury Road, Westmead, New South Wales 2145, Australia.

出版信息

Clin Chest Med. 2019 Dec;40(4):797-810. doi: 10.1016/j.ccm.2019.08.003.

DOI:10.1016/j.ccm.2019.08.003

PMID:31731985

Abstract

Children carry a significant tuberculosis disease burden in settings with poor epidemic control and high levels of transmission. Even in high-resource settings, the diagnosis of tuberculosis in children can be challenging, but an accurate diagnosis can be achieved by adopting a systematic approach. This review outlines the general principles of tuberculosis prevention in children, including epidemic control, infection control, contact tracing and preventive therapy, and vaccination; diagnosing pediatric tuberculosis, including specimen collection and microbiological confirmation, highlighting key differences from adults; and tuberculosis treatment in children, including treatment of severe disease that mostly occurs in young children and drug-resistant tuberculosis.

摘要

儿童在控制不佳且传播水平高的环境中承担着重大的结核病负担。即使在资源丰富的环境中，儿童结核病的诊断也具有挑战性，但通过采用系统方法仍可实现准确诊断。本文综述了儿童结核病预防的一般原则，包括流行控制、感染控制、接触者追踪和预防性治疗与疫苗接种；介绍了儿童结核病的诊断方法，包括标本采集和微生物学确认，并突出了与成人的关键差异；讨论了儿童结核病的治疗，包括主要发生在幼儿中的重症疾病和耐药结核病的治疗。