Tuberculosis in Children in a Pediatric Hospital in Mexico

Am J Trop Med Hyg. 2021 Nov 22;106(1):75-79. doi: 10.4269/ajtmh.20-1482.

Abstract

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl-Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Coloring Agents
  • Female
  • Hospitals, Pediatric*
  • Humans
  • Male
  • Mexico / epidemiology
  • Mycobacterium tuberculosis / isolation & purification
  • Pathology, Molecular
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tuberculosis* / diagnosis
  • Tuberculosis* / epidemiology
  • Tuberculosis* / pathology
  • Tuberculosis, Lymph Node / diagnosis
  • Tuberculosis, Lymph Node / epidemiology
  • Tuberculosis, Lymph Node / pathology
  • Tuberculosis, Meningeal / diagnosis
  • Tuberculosis, Meningeal / epidemiology
  • Tuberculosis, Meningeal / pathology
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / pathology

Substances

  • Coloring Agents