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18岁及以下患者结核病的临床和影像学特征及治疗结果:一项前瞻性研究。

Clinical and radiological profile of tuberculosis and treatment outcome in patients ≤18 years: A prospective study.

作者信息

Madhuri Kolla, Subhankar Saswat, Mohapatra Amrut K, Jagaty Suman K, Behera Debasis, Das Abhisek, Parida Shrutakirty, Mishra Swadip

机构信息

Department of Respiratory Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India.

Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.

出版信息

J Family Med Prim Care. 2025 May;14(5):1716-1721. doi: 10.4103/jfmpc.jfmpc_1352_24. Epub 2025 May 31.

Abstract

BACKGROUND

Tuberculosis is an important cause of morbidity and mortality in children, especially in endemic countries. The diagnosis of tuberculosis in these patients is challenging due to various reasons. The outcome of treatment in these patients is also varied.

AIMS AND OBJECTIVES

Our study aims to determine the various types of presentations of tuberculosis; describe the clinical, radiological and microbiological characteristics and also study the outcome of treatment in patients ≤ 18 years of age.

MATERIALS AND METHODS

It was a prospective study. We included all newly diagnosed consecutive cases of pulmonary or extra pulmonary TB in patients (up to 18 years of age). After a detailed history and complete physical examination, AFB smear and CBNAAT of samples and radiology were performed. Follow-up of all cases was done at the end of intensive phase (IP) and at the end of treatment or at any time as needed. All statistical analyses were performed using SPSS version 19.0.

RESULTS

A total of 105 cases were included in our study. Most cases belonged to the age group of 7-14 yrs. Pulmonary tuberculosis (PTB) was diagnosed in 37 cases (35.2%), followed by TB lymphadenitis (31.4%). Microbiological confirmation could be obtained only in 53 cases (50.47%). Joint pain and a derangement in liver function test were the most common adverse effects (4 cases) and 1 case developed optic atrophy.

CONCLUSION

A combination of history, signs and symptoms, and radiology may help reach a diagnosis in children. The risk of serious adverse events in children associated with the use of the recommended treatment regimens is also very low. Children and their family members should be educated about TB and the importance of completing treatment.

摘要

背景

结核病是儿童发病和死亡的重要原因,尤其是在结核病流行国家。由于多种原因,这些患者的结核病诊断具有挑战性。这些患者的治疗结果也各不相同。

目的

我们的研究旨在确定结核病的各种表现类型;描述临床、放射学和微生物学特征,并研究18岁及以下患者的治疗结果。

材料与方法

这是一项前瞻性研究。我们纳入了所有新诊断的连续性肺或肺外结核病患者(年龄至18岁)。在进行详细的病史询问和全面的体格检查后,对样本进行抗酸杆菌涂片和CBNAAT检测以及放射学检查。所有病例在强化期结束时、治疗结束时或根据需要随时进行随访。所有统计分析均使用SPSS 19.0版进行。

结果

我们的研究共纳入105例病例。大多数病例属于7 - 14岁年龄组。37例(35.2%)诊断为肺结核(PTB),其次是结核性淋巴结炎(31.4%)。仅53例(50.47%)获得微生物学确诊。关节疼痛和肝功能检查异常是最常见的不良反应(4例),1例出现视神经萎缩。

结论

病史、体征和症状以及放射学检查相结合可能有助于儿童结核病的诊断。与使用推荐治疗方案相关的儿童严重不良事件风险也非常低。应向儿童及其家庭成员宣传结核病知识以及完成治疗的重要性。

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