Delacourt C, Mani T M, Bonnerot V, de Blic J, Sayeg N, Lallemand D, Scheinmann P
Department of Paediatric Pneumonology, Hôpital des Enfants Malades, Paris, France.
Arch Dis Child. 1993 Oct;69(4):430-2. doi: 10.1136/adc.69.4.430.
Children with primary tuberculosis infection without disease must be identified and treated preventively to avoid an increase in the incidence of tuberculosis in children. However, the recognition of infected cases without disease is often difficult. In particular, minimal active disease may be present in many cases but unrecognised on chest radiography. Computed tomography was therefore performed in 15 children with tuberculous infection and a normal chest radiograph to measure the size of their mediastinal lymph nodes. Ten control children without tuberculosis were also evaluated. When compared with controls it was found that nine of 15 (60%) infected children had enlarged lymph nodes. Adenopathies were more frequent in infected children less than 4 years old than in those over 8 years old. The demonstration of unrecognised active disease in many infected children raises the question of the adequate treatment for these children. It is proposed that a two drug regimen would be more appropriate than isoniazid alone in these cases.
必须识别出患有原发性结核感染但无疾病的儿童并对其进行预防性治疗，以避免儿童结核病发病率上升。然而，识别出无疾病的感染病例往往很困难。特别是，许多病例可能存在轻微活动性疾病，但胸部X线检查未发现。因此，对15例结核感染且胸部X线正常的儿童进行了计算机断层扫描，以测量其纵隔淋巴结大小。还对10名无结核病的对照儿童进行了评估。与对照组相比，发现15名感染儿童中有9名（60%）淋巴结肿大。4岁以下感染儿童的腺病比8岁以上儿童更常见。许多感染儿童中未被识别的活动性疾病的发现，引发了对这些儿童适当治疗的问题。有人提出，在这些病例中，两药联合方案比单独使用异烟肼更合适。
