Extra Pulmonary Tuberculosis in Children: Two Years Study

  • Nooshin Baghaie Pediatric Respiratory Diseases Research Center, National Research Center of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
  • Soheila Khalilzade Research Center, National Research Center of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
  • Mohammad Reza Boloursaz Research Center, National Research Center of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
  • Amir Ali Khodayari Research Center, National Research Center of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
  • Ali Akbar Velayati Research Center, National Research Center of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Keywords: Mycobacterium tuberculosis, tuberculosis, pediatrics

Abstract

Tuberculosis (TB) is an important health problem in developing countries, with varying clinical presentations depending on the organs/systems involved. To study the spectrum of clinical and paraclinical aspects of extra pulmonary TB in children suffering from pulmonary TB. This study has been carried out on 65 children with tuberculosis, admitted in TB wards of National Research Institute of Tuberculosis and Lung Disease (N.R.I.T.L.D) during 2004-2006. All patients were investigated according to specific diagnostic criteria including; history of contact with TB patient, clinical manifestations, radiological findings, tuberculin test and bacteriologic or pathologic results and after confirmation, treatment was administered. Out of 65 cases, 14 had different types of extra pulmonary tuberculosis, and data concerning following factors were studied: age, gender, race, site of involvement, bacteriology, pathology, ADA (ascitic fluid), PCR (tissue specimens), history of close contact, HIV tests (ELISA), tuberculin test, radiological findings, and immunological studies (in disseminated TB). Of 14 cases, 8 were girls and 6 were boys with mean age of 8.75±4.2. Nine patients were Iranian and 5 were Afghan. History of close contact was detected in 4 cases. Type of involvement was: 5 cervical adenitis, 3 osteoaticular disease, 2 peritonitis and 2 disseminated form of tuberculosis, one pericarditis, one renal tuberculosis. Radiological findings showed 4 pulmonary disease and 3 osteoarticular involvement. Tuberculin skin tests greater than 15 mm observed in 5 cases, 9 patients had 0-5 mm induration. 4 cases had concomitant pulmonary and extra pulmonary involvement. Positive AFB in gastric lavage was recognized in 4 cases, in which 3 showed positive cultures for MTB. Pathological examinations in 10 cases revealed granuloma with caseation compatible with tuberculosis, five in lymphadenopaty, three in osteoarticular, two in abdominal tuberculosis. According to this study, 20% of patients had extra pulmonary involvement, which is comparable to other reports (20-25%) and TB lymphadenitis is the most common from of presentation.

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How to Cite
1.
Baghaie N, Khalilzade S, Boloursaz MR, Khodayari AA, Velayati AA. Extra Pulmonary Tuberculosis in Children: Two Years Study. Acta Med Iran. (No. 4):239-243.
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