Department of Infectology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico.
Department of Pharmacology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico.
Am J Trop Med Hyg. 2021 Nov 22;106(1):75-79. doi: 10.4269/ajtmh.20-1482.
Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl-Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.
结核病(TB)仍然是一个全球性问题,也是一个诊断挑战,尤其是在儿科领域。本研究旨在描述儿童结核病的临床、微生物学、影像学和组织病理学数据。这是一项回顾性和描述性的 7 年队列研究,纳入了 2011 年至 2018 年期间在一家儿童医院确诊为活动性结核病的 127 名 18 岁以下的患者。共有 94 例(74%)通过 Ziehl-Neelsen(ZN)染色、培养或聚合酶链反应(PCR)证实为结核病。33 例基于结核菌素皮肤试验结果和流行病学评估被定义为可能的结核病。发现的结核病形式包括淋巴结(39.3%)、骨骼(15.7%)、肺部(13.6%)和脑膜结核(8.6%)。最常见的症状是发热(48.8%)和腺病(45.6%)。34.6%的患者有接触史。ZN 染色阳性(敏感性 30%)和培养阳性(敏感性 37%)分别见于 29%和 37.7%的患者。约 64.5%的患者出现异常的胸部 X 射线。Xpert MTB/RIF®(PCR)在 9.4%的样本中呈阳性,活检在 52.7%的样本中呈阳性。对疾病进行实验室和流行病学评估以支持诊断并确定其治疗方法至关重要;因为在大多数情况下,缺乏早期微生物学确认。