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Diagnosis of paediatric tuberculosis: the culture conundrum.儿童结核病的诊断:培养难题
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儿童结核病临床及实验室特征评估

Evaluation of clinical and laboratory characteristics of childhood tuberculosis.

作者信息

Aygün Deniz, Yıldırım Tarık, Öner Özlem Başoğlu, Şiraneci Rengin

机构信息

Division of Pediatric Infectious Diseases, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Pediatri Ars. 2020 Sep 23;55(3):236-243. doi: 10.14744/TurkPediatriArs.2020.02438. eCollection 2020.

DOI:10.14744/TurkPediatriArs.2020.02438
PMID:33061750
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7536459/
Abstract

AIM

Tuberculosis is one of the oldest and most contagious diseases of human history. One- quarter of the world's population is infected with the tuberculosis bacillus. Childhood tuberculosis does not have a standard clinical and radiologic description. Herein, we aimed to evaluate the clinical, laboratory, and radiologic findings of childhood tuberculosis.

MATERIAL AND METHODS

The medical records of 216 patients hospitalized and treated with a diagnosis of TB between January 2015 and July 2019 in the Division of Pediatric Infectious Diseases in our hospital, were examined retrospectively.

RESULTS

One hundred twenty-nine (59.7%) of 216 patients who were diagnosed as having TB were female and 87 (40.3%) were male. The age distribution of the patients was 12.3 (range, 0.33-18) years. One hundred sixty-nine patients (78.2%) had pulmonary, 34 (15.7%) had extrapulmonary, 13 had (6%) both pulmonary and extrapulmonary. One hundred forty-three (66.2%) patients had tuberculin skin test positivity. Acid-resistant bacteria were observed in 46 (21.3%) body fluid samples, and culture positivity was observed in 42 (19.4%) samples. The association of pulmonary tuberculosis and extrapulmonary tuberculosis was found with a higher rate in individuals who lived on minimum wage and in patients who had growth and developmental retardation (p=0.001, p<0.001). The hospitalization time was longer in these patients (p=0.027). The hemoglobin and sodium levels were significantly lower in patients who had extrapulmonary tuberculosis (p=0.044, p=0.002).

CONCLUSION

Although the diagnosis of childhood tuberculosis is difficult due to the nonspecific signs and symptoms, it is a preventable and treatable disease.

摘要

目的

结核病是人类历史上最古老且传染性最强的疾病之一。世界四分之一的人口感染了结核杆菌。儿童结核病尚无标准的临床和影像学描述。在此,我们旨在评估儿童结核病的临床、实验室及影像学表现。

材料与方法

回顾性分析我院儿科传染病科2015年1月至2019年7月期间住院并诊断为结核病的216例患者的病历。

结果

216例被诊断为结核病的患者中,129例(59.7%)为女性,87例(40.3%)为男性。患者的年龄分布为12.3岁(范围0.33 - 18岁)。169例(78.2%)患者患有肺结核,34例(15.7%)患有肺外结核,13例(6%)同时患有肺结核和肺外结核。143例(66.2%)患者结核菌素皮肤试验呈阳性。46例(21.3%)体液样本中观察到抗酸杆菌,42例(19.4%)样本培养呈阳性。在领取最低工资的人群和生长发育迟缓的患者中,肺结核与肺外结核的关联率更高(p = 0.001,p < 0.001)。这些患者的住院时间更长(p = 0.027)。肺外结核患者的血红蛋白和钠水平显著较低(p = 0.044,p = 0.002)。

结论

尽管由于非特异性体征和症状,儿童结核病的诊断困难,但它是一种可预防和可治疗的疾病。