1637. Tuberculosis in Children Under 1 Year of Age in a Third Level Hospital in Mexico City
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Tuberculosis (TB) in children is the result of the disease in adults and a reliable indicator of transmission in the community. Characteristically, TB in children has a rapid progression.

Methods: An observational, cross-sectional, retrospective and descriptive study. We reviewed the clinical files of patients from 1993 through 2012 with clinical suspicion of TB and positive culture or 3 or more of the following: imaging suggestive of TB, positive PPD, positive COMBE (TB contact), cerebrospinal fluid suggestive, acid fast bacilli (AFB) smear positive

Results: We included 22 children, the mean age at diagnosis was 6.6 months, with 81.8% male predominance. 86.4% of the children received BCG vaccine, 63.6% had positive COMBE, the mean duration of signs and symptoms was of 70.5 days, none had history of infection with human immunodeficiency virus, and one was diagnosed with chronic granulomatous disease.
The signs and symptoms were fever (72.7%), cough (59.1%), irritability (40.9%), hyporexia (36.4%), weight loss (22.7%), lymphadenopathy (18.2%), growth failure (18.2%), seizures (13.6%) and diarrhea (13.6%).                   
The chest X-ray was abnormal in 45.5%, 36.4% had positive PPD and 27.3% had a positive AFB. Mycobacterium tuberculosis was isolated in 22.7% and Mycobacterium bovisin 4.5%. The most common presentation was pulmonary in 40.9%, followed by the meningeal form in 18.2%; the missing 40.9% included lymphatic, abdominal, peritoneal, miliary, osseous and of skin. A 27.2% had sequelae, most of them were neurological including hydrocephalus, spasticity and paralysis of the seventh pair. No deaths were documented.

Conclusion: TB in children under one year of age has different forms of presentation, being the meningeal form the most severe and with the greatest percentage of sequelae. The diagnosis of TB in this age group generally is done belatedly, so it is important to think about it to prevent serious sequelae and death.

Napoleon Gonzalez Saldaña, MD, Infectious Disease, instituto nacional de pediatria, Mexico, Mexico, Ricardo Valentin Narvaez Arzate, MD, instituto nacional de peditria, Mexico, Mexico, Valeria Gomez, MD, INFECTIOUS DISEASES , INSTITUTO NACIONAL DE PEDIATRIA, MEXICO, Mexico and Marte Hernandez Sr., MD, INFECTIOUS DISEASES, INSTITUTO NACIONAL DE PEDIATRIA, MEXICO, Mexico


N. Gonzalez Saldaña, None

R. V. Narvaez Arzate, None

V. Gomez, None

M. Hernandez Sr., None

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