1198. Changing Face of Tuberculosis in Children
Session: Poster Abstract Session: Other Bacterial Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background: 

To evaluate the clinical characteristics and outcome of treatment in children with tuberculosis

Methods: 

We reviewed the medical records of children followed at our hospital with a diagnosis of tuberculosis (TB) between May 2007-April 2011. Tuberculosis was confirmed by isolation of Mycobacterium tuberculosis (M. tuberculosis) from body fluids in cases with clinical and/or imaging findings compatible with the disease. In case of negative cultures, TB was defined by histopathological evidence of mycobacterial infection and/or with positive tuberculin skin test (TST), history of exposure to tuberculosis, and detection of acid-fast bacilli (AFB) in body fluids.

Results: 

Median age of 57 patients with TB was 7.5 years (range, 0.2-17 years) and 21% of the cases were younger than 2 years. Twenty-six (45.6%) of cases had only pulmonary disease, and 31 (54.4%) had extrapulmonary TB. Thirteen of 31 cases with extrapulmonary disease also had pulmonary TB. The most common sites of extrapulmonary TB were pleural (n:9, median age: 9 years, range: 2.5-17 years), bone and joint (n: 6, median age: 2.75 years, range: 1.5-12 years), disseminated (n: 6, median age: 6.1 years, range: 0.2-14 years), and abdominal (n: 4, median age: 12 years, range: 10-16 years). M. tuberculosis was isolated in 6 (10.5%) cases from gastric aspirate (n: 5) and joint fluid (n: 1). In 14 patients, TB was confirmed by histopathological findings (6 cases with bone and joint TB, 4 with abdominal, 2 with disseminated TB, and 2 with lymphadenitis).  BCG vaccination scar was detected in 77.7% of the cases. TST was positive in 81% of the cases and 31.6 % of the cases had a person with active TB in the family. Isoniazid resistance was found in 1, and streptomycin resistance in 2 strains. Thirty-seven (65%) cases completed treatment, and 13 (22.8%) cases are still on the treatment. We lost track of 7 (12.2%) patients. No case expired.

Conclusion: 

Extrapulmonary TB accounted for a high proportion of TB in children in this study. Children with TB, even young children, can present with atypical pictures such as bone and joint findings. Early diagnosis and treatment is important on the prognosis.  


Subject Category: P. Pediatric and perinatal infections

Gülnar Sensoy, Professor1, Nursen Belet, Associate, Professor1, Semir Nehir, MD2, Muhammet Akgun1 and Ayse Ayzit Kilinc2, (1)Pediatric Infectious Diseases, Ondokuz Mayis University, Samsun, Turkey, (2)Pediatrics, Ondokuz Mayis University, Samsun, Turkey

Disclosures:

G. Sensoy, None

N. Belet, None

S. Nehir, None

M. Akgun, None

A. A. Kilinc, None

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