Tuberculosis in children true is
Correct Answer: All of the above
Description: Tuberculosis in children :
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis.
Cases of tuberculosis represent 5 - 15 percent of all tubercular cases.
Clinical manifestations of TB in children :
The majority of children with tuberculosis infection develop no signs or symptoms at any level.
Occasionally.
Infection is marked by low - grade fever, mild cough, malaise and u - like symptoms.
A) Primary pulmonary disease the lung is the portal of entry in > 98% of cases.
The primary complex of tuberculosis includes local infection at the portal of entry and regional lymph nodes that drain the area.
The combination of the parenchymal pulmonary - lesion and corresponding lymph node is called Ghon complex.
Asymptomatic pleural effusion is so frequent in primary - tuberculosis that it is basically a component of the primary complex.
Nelson, It may have one of the following course : - Heating by brosis and calcification.
Progressive primary > tuberculosis. Cavity Obstructive emphysema If the incomplete obstruction is caused by lymph nodes.
Resorption atelectasis If the complete obstruction is caused by lymph nodes.
Tubercular bronchitis & bronchiectasis Hematogenous dissemination During early bacteremia seeding may occur at apex Simon's focus.
Miliary tuberculosis Collapse consolidation (segmental lesion) A combination of pneumonitis and atelectasis.
B) Chronic pulmonary tuberculosis :
Infrequent in young children.
Children above the age of seven years, especially girls are more vulnerable.
The commonest site of chronic pulmonary tuberculosis is the apex of lung Puhl's lesion.
Infraclavicular lesion of chronic pulmonary tuberculosis is called Assman's focus.Regional lymph nodes are not involved in chronic pulmonary TB (in contrast to primary TB). Lab investigations of pediatric TB.
ESR and blood counts : No value in diagnosis or follow up of TB.
Demonstration of AFB.
Children don't expectorate out sputum, but swallow it.
Therefore sputum is not available for examination.
A laryngeal swab may be obtained for smear and culture examination for mycobacteriaIt is customer to examine the gastric lavage in children for bacteriological examination on 3 consecutive days, Aspiration of early morning gastric contents (before breakfast) is done with a Ryle's tube and sent for bacteriological examination. Adding vancomycin to the sample improves the yield of mycobacterium. The CSF, Pleural did or bronchial aspirate, urine and discharges from tuberculous sinuses are examined for tubercle bacilli. Histopathology : Material for histopathology may be obtained by biopsy or FNAC.
PCR : High sensitivity and specificity for pleural uid and low for gastric aspirate. CXR and CT may show characteristic features.
USG may be helpful for the detection of enlarged abdominal lymph nodes,
Serology : Elisa or other methods have no utility in pediatric TB. Antitubercular drugs used in children.
First line drugs : Isoniazid, Rifampicin, EthambutoL Streptomycin, Pyrazinamide.
Second line drugs : Cycloserine, Ethionamide, PAS, Capreomycin, Kanamycin.
Other drugs. Quinolones Ooxacin, Rifamycin, Amikacin, Imipenem, Ampicillin.
Category:
Pediatrics
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