Clinical presentation of pulmonary tuberculosis in under 10s and differences in AIDS-related cases: a cohort study of 115 patients.

One hundred and fifteen cases of pulmonary tuberculosis (PTB) in children under 10 were reviewed, including a case-control retrospective study between HIV positive (+ve) and HIV negative (-ve) children. Overall, respiratory symptoms not responding to acute respiratory infection (ARI) protocol and > 10% weight loss or failure to thrive during 3 months were the main presenting symptoms, but chronic fever alone is also common in HIV infected children with PTB. Hylar enlargement is the most frequent radiologic pattern, although lobar infiltrates are common when HIV infection coexists. Gastric lavage culture was an important diagnostic tool but Mantoux test, gastric lavage direct smear and erythrocyte sedimentation rate (ESR) levels, were not helpful in diagnosing PTB. Our findings suggest that when HIV infection is suspected or confirmed, chronic fever and lower lobe infiltrates should also be considered as PTB warning signs.