Tuberculose em Idade Pediátrica: Experiência de 12 Anos num Centro Terciário de Referência em Portugal

Introduction: The diagnosis of tuberculosis in children is a challenge namely because extrapulmonary tuberculosis and severe disease are more frequent in this age group. The aim of this study was to evaluate and reflect about severe tuberculosis in pediatric age, in a metropolitan area of Lisbon.Material and Methods: Descriptive study about patients under 18 years of age admitted with tuberculosis disease in a tertiary pediatric hospital, from 2008 to 2019 (12 years).Results: We report 145 patients, average of 12 cases/year, with an increase in the last three years. Median age of 12.9 years, 42.8% born in Portuguese-speaking African countries and 20% had a chronic disease. The diagnosis was pulmonary tuberculosis in 52.4% (n = 76) and extrapulmonary tuberculosis in 47.6%: lymphatic (n = 26), skeletal (n = 15), miliary (n = 8), meningeal (n = 7), peritoneal/ intestinal (n = 6), pleural (n = 4), renal (n = 1), cutaneous (n = 1), thoracic wall (n = 1) and salivary glands (n = 1). The tuberculin test was positive in 78/99 (78.8%) and Interferon Gamma Release Assay in 61/90 (67.8%). In 20.7% (n = 30) acid-fast bacilli were identified in gastric aspirate/sputum and the agent was identified in 59.3% (n = 86). Tuberculosis was resistant in 11% (n = 16). Patients with extrapulmonary tuberculosis were younger (p = 0.006) and had more prolonged therapy (p < 0.001). Therapy-related complications occurred in 11% (n = 16). One patient died (with terminal cancer).Conclusion: This study highlights the need for screening of tuberculosis in children from endemic countries, patients with immunosuppression and chronic disease.

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Interferon-Gamma Release Assay Improves the Diagnosis of Tuberculosis in Children

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e31819abf6b ◽

2009 ◽

Vol 28 (6) ◽

pp. 510-514 ◽

Cited By ~ 79

Author(s):

Leila Bianchi ◽

Luisa Galli ◽

Maria Moriondo ◽

Giuseppina Veneruso ◽

Laura Becciolini ◽

...

Keyword(s):

Interferon Gamma ◽

Interferon Gamma Release Assay ◽

Release Assay ◽

Tuberculosis In Children

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Abdominal tuberculosis in children

Paediatrica Indonesiana ◽

10.14238/pi41.3.2001.155-9 ◽

2001 ◽

Vol 41 (3) ◽

pp. 155

Author(s):

Heda Melinda Nataprawira ◽

Henny Komalia

Keyword(s):

Extrapulmonary Tuberculosis ◽

Abdominal Tuberculosis ◽

Point Of View ◽

Gastric Aspirate ◽

Abdominal Symptoms ◽

Clinical Point ◽

Chest X Ray ◽

Tuberculosis In Children ◽

Positive Results ◽

Pleural Involvement

Abdominal tuberculosis is one of the extrapulmonary tuberculosis commonly found in adolescens, however, due to its non-specific and vague abdominal symptoms, it is rarely found and reported in children. To evaluate abdominaltuberculosis in children from clinical point of view, we conducted a 5-year retrospective study on children hospitalized over a period of 1995 to 1999 in Hasan Sadikin Hospital-Bandung. Of the 15 children diagnosed as having abdominal tuberculosis, 10 (66.7%) were female and 5 (33,3%) male, age ranged from 14 – 162 months and most of them were > 10 years of age.On admission, abdominal distention was the most common complaint found (60.0%), followed by dyspnoe 3 (20.0%), abdominal pain 2 (13.3%) and generalized oedem 1 (6.7%). Most of the children (93.3%) were undernourished which half of them were severely undernourished. Seven children showed positive Mantoux testing with PPD 5 TU. There was familyhistory of adults TB discovered in 9 (60%) of the children. Eighty-percent had BCG vaccination and 6 (50%) of the showed positive scarr. Chest X-ray showed pulmonal and/or pleural involvement in 13 of the 15 children (86.7%). All ascitic fluid taken from 9 patients showed increased protein level and lymphocyte predominance. Histopathologic examinations of 5 childrensupported the diagnosis. There was no positive results of acid fast bacilli and culture done for Mycobacterium tuberculosis in gastric aspirate as well as ascitic fuid. Peritonitis tuberculosis was most commonly diagnosed (80.0%), followed by mesenterial/nodal tuberculosis (20.0%). All of the children followed (60.0%) responded well to the drugs therapy.

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Diagnostic utility of interferon-gamma release assay in extrapulmonary tuberculosis

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2015.02.002 ◽

2015 ◽

Vol 82 (1) ◽

pp. 44-48 ◽

Cited By ~ 5

Author(s):

Jung Ar Shin ◽

Yoon Soo Chang ◽

Hyung Jung Kim ◽

Chul Min Ahn ◽

Min Kwang Byun

Keyword(s):

Interferon Gamma ◽

Extrapulmonary Tuberculosis ◽

Interferon Gamma Release Assay ◽

Diagnostic Utility ◽

Release Assay

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Latent tuberculosis infection and tuberculosis in children and adolescents

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4090 ◽

2018 ◽

Vol 16 (3) ◽

Author(s):

Cassia Satsuki Ishikawa ◽

Olivia Mari Matsuo ◽

Flavio Sarno

Keyword(s):

Computed Tomography ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculin Test ◽

Tuberculosis Infection ◽

Gastric Aspirate ◽

X Ray ◽

Qualitative Variables ◽

Chest X Ray ◽

Tuberculosis In Children

ABSTRACT Objective: To describe the characteristics of patients diagnosed with tuberculosis and latent tuberculosis infection. Methods: A retrospective study, between 2012 and 2015, with data from patients of Programa Einstein na Comunidade de Paraisópolis. To evaluate possible factors associated with patient's sex and diagnoses of tuberculosis and latent tuberculosis infection, χ2 or Fisher's exact tests were used for qualitative variables, and Mann-Whitney test for quantitative or ordinal qualitative variables. Results: A total of 77 patients were evaluated. Age ranged from 6 months to 13.4 years, with a majority of males (54.5%), aged zero to 4 years (54.5%), diagnosed with latent tuberculosis infection (64.9%), and classified as eutrophic (71.2%). The tuberculin test was positive in 92% and in most cases the values were above 10mm (68.0%). Approximately three-quarters of chest X-ray tests were normal (72.7%). After chest X-ray, computed tomography of thorax was the most ordered exam (29.9%), followed by smear and culture for Mycobacterium tuberculosis in the gastric aspirate (28.6%). The frequencies of altered chest X-ray (70.4% versus 4.0%), computed tomography of thorax requests (55.6% versus 16.0%) and other tests requested (81.5% versus 38.0%) were significantly higher in patients with a diagnosis of tuberculosis, relative to those with latent tuberculosis infection, respectively. Conclusion: In our sample, proportions of altered chest X-ray, and performing computed tomography of thorax and other tests in patients diagnosed with tuberculosis were higher than in those with latent tuberculosis infection.

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