Ans. is 'None' All may occur Tuberculosis in children Tuberculosis is a chronic infectious disease caused by mycobacterium tuberculosis. o Cases of tuberculosis represent 5-15 precent 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, mailaise and flulike symptoms. A. Primary pulmonary disease The lung is the poal of entery in > 98% of cases. Primary complex of tuberculosis includes local infection at he poal of entry and regional lymphnodes that drain the area. The combination of the a 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 primary complex. - Nelson Primary complex may have one of the following course : - i) Healing by fibrosis and calcification. ii) Progressive primary tuberculosis. iii) Cavity iv) Obstructive emphycema ---> If incomplete obstruction is caused by lymph nodes. v) Resorption atelectesis If complete obstruction is caused by lymph nodes. vi) Tubercular bronchits & brionchiactasis vii) Hematogenous dissemination --> During early bacteremia seeding may occur at apex Simon's focus. viii) Miliary tuberculosis ix) Collapse consolidation (segmental lesion) A combination of pneumonitis and atelectosis. B. Chronic pulmonary tuberculosis Infrequent in young children Children above the age of seven years, especially girls are more vulnerable. Commonest site of chronic pulmonary tuberculosis is 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).