Gómez-Pastrana Durán D, Caro Mateo P, Torronteras Santiago R, Anguita Quesada M L, López Barrio A M, Andrés Martín A, Navarro González J
Sección de Neumología Pediátrica, Hospital Infantil Universitario Virgen del Rocío, Sevilla.
Arch Bronconeumol. 1996 Dec;32(10):500-4. doi: 10.1016/s0300-2896(15)30684-0.
The recognition of children with tuberculous infection without disease is often difficult. Minimal active disease may be present in many cases but unrecognised on chest radiography or by microbiologic methods. We have performed computed tomography in 22 children with tuberculous infection, a normal chest radiograph and negative microbacterial culture. In 16 children we also performed DNA amplification by polymerase chain reaction in gastric aspirates. It was found that 14 of 22 (63%) infected children had enlarged lymph nodes. Adenopathies were more frequent in children less than 8 years-old and in the right paratracheal positions. Polymerase chain reaction was positive in 4 of 8 studied children with abnormal computed tomography and in none of the children with normal computed tomography. The demonstration of unrecognised active disease raises the question of the adequate treatment for the children with tuberculous infection. It is proposed that a two drug regimen would be more appropriate than isoniazid alone in children less than 8 years old.
识别出患有结核感染但无疾病表现的儿童往往很困难。许多病例中可能存在轻微活动性疾病，但在胸部X线检查或微生物学方法中未被识别。我们对22名患有结核感染、胸部X线检查正常且细菌培养阴性的儿童进行了计算机断层扫描。在16名儿童中，我们还对胃抽吸物进行了聚合酶链反应的DNA扩增。结果发现，22名受感染儿童中有14名（63%）有淋巴结肿大。淋巴结病在8岁以下儿童及右气管旁位置更为常见。在8名计算机断层扫描异常的研究儿童中，4名聚合酶链反应呈阳性，而计算机断层扫描正常的儿童中无一例呈阳性。未被识别的活动性疾病的发现引发了对结核感染儿童适当治疗的问题。有人提出，对于8岁以下儿童，两药联合方案比单独使用异烟肼更合适。
