Chung J L, Lin T Y
Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1993 Mar;16(1):19-24.
Extrapulmonary tuberculosis is not a rare infection of children in Taiwan. From 1985 to 1989, we studied 39 children with the diagnosis of extrapulmonary tuberculosis from a total of 43 sites. They were diagnosed by routine diagnostic tests including bacteriologic cultures in 11, pathological features in 25, and clinical presentations in 2 patients. Positive mycobacterial DNA probe method was obtained from a patient with tuberculous meningitis. The most common sites of involvement were lymph nodes in 9 (20.9%), meninges in 7 (16.3%), bone in 7 (16.3%), joint in 6 (14.0%) and miliary infection in 6 (14.0%). The median age of the 2 patients with renal tuberculosis was 14.5 years, which was older compared to the patients with other organ systems involvement. Tuberculin skin tests were significantly positive (> 10 mm) in 54% of the tested children. Among the treated patients, 76% were cured after 9 to 12 months of antituberculous chemotherapy without sequelae, while 24% had sequelae associated with tuberculous infection despite treatment. There was no death reported during the study period. We conclude that extrapulmonary tuberculosis remains an important health problem to the pediatric population of this island despite the overall decline in the incidence of tuberculosis. Early detection and thorough treatment for a suitable period are mandatory to improve the prognosis of this potentially curable infectious disease.
肺外结核在台湾并非儿童罕见感染病。1985年至1989年，我们对来自43个部位的39例诊断为肺外结核的儿童进行了研究。他们通过常规诊断测试确诊，其中11例通过细菌培养，25例通过病理特征，2例通过临床表现。1例结核性脑膜炎患者的结核分枝杆菌DNA探针检测呈阳性。最常受累的部位为淋巴结9例（20.9%）、脑膜7例（16.3%）、骨骼7例（16.3%）、关节6例（14.0%）和粟粒性感染6例（14.0%）。2例肾结核患者的中位年龄为14.5岁，比其他器官系统受累的患者年龄大。54%的受试儿童结核菌素皮肤试验呈显著阳性（>10mm）。在接受治疗的患者中，76%在接受9至12个月抗结核化疗后治愈且无后遗症，而24%尽管接受了治疗仍有与结核感染相关的后遗症。研究期间无死亡报告。我们得出结论，尽管结核病总体发病率有所下降，但肺外结核仍是该岛儿科人群的一个重要健康问题。早期发现并进行适当疗程的彻底治疗对于改善这种潜在可治愈传染病的预后至关重要。
