EXTRA-PULMONARY TUBERCULOSIS IN CHILDREN: A STUDY OF 41 CASES

##plugins.themes.academic_pro.article.sidebar##

Published Dec 4, 2009
Download
pdf
Vol. 87 No. 10 (2009): Issue Oct 2009

##plugins.themes.academic_pro.article.main##

Faten Tinsa
Leila Essaddam
Zohra Fitouri
Faouzi Nouira
Wiem Douira
Saida Ben Becher
Khadija Boussetta
Souad Bousnina

Abstract

Background: Extrapulmonary tuberculosis accounts for up to one third of all cases of tuberculosis and children show a higher predisposition to the development of extra-pulmonary tuberculosis
Aim: To review the clinical features of the extrapulmonary tuberculosis in children.
Methods: forty one children with extrapulmonary tuberculosis followed in the Children Hospital of Tunis between January 1995 and December 2007 were reviewed.
Results: Extrapulmonary tuberculosis constitutes 57.9 % of all cases of tuberculosis. Male to female ratio was 0.7 and the mean age was 7.5 years. The most commonly involved sites were the peripheral lymphadenitis (14 cases) followed by abdominal (11 cases), central nervous system (7 cases), osteoarticular (5 cases) and multifocal ( 4 cases). A positive family history of active tuberculosis was detected in 22.5% of the cases. Diagnosis delay was 4.7 months. Sequelae
observed during the follow up were: neurosensory in 5 cases, and vertebral deformation in 1 case.
Conclusion: extrapulmonary tuberculosis represents an important fraction of tuberculosis in our study. The most common form is lymph nodes localization followed by abdominal and central system nervous forms. Neurosensory sequelae were frequent in central system nervous tuberculosis.

Keywords:

Tuberculosis, extrapulmonary, child

##plugins.themes.academic_pro.article.details##

References

  1. Raviglione MC, Snider DE, Kochi A. Global pidemiology of tuberculosis. Morbidity and mortality of a worldwide epidemic. JAMA 1995; 273 :220-6
  2. Direction de soins de santé de base, ministère de la santé publique. République Tunisienne, guide pratique programme lutte antituberculeuse 1999
  3. RiederHL, Snider DE Jr, Cauthen GM. Extra-pulmonary tuberculosis in the United States. Am Rev Respir Dis 1990; 141:347-51
  4. Weir MR, Thornton GF. Extra-pulmonary tuberculosis. Experience of a community hospital and review of the literature. Am J Med 1985;79:467-78
  5. Starke JR. Resurgence of tuberculosis in children. Pediatr Pulmonol 1995;11(suppl):16-17.
  6. Smith S, Jacobs RF, Wilson CB. Immunobiology of childhood tuberculosis: a window o n the ontogeny of cellular immunity. J Pediatr 1997;131:16-26
  7. Cantwell MF, McKenna MT, McCray E, Onorato IM. Tuberculosis and race/ethnicity in the United States. Am J Respir Crit Care Med 1998;157:1016-20.
  8. Kampmann B, Young D. Childhood tuberculosis: advances in immunopathogenesis, treatment and prevention. Curr Opin Infect Dis 1998;11:331-5
  9. Snider DE Jr, Rieder HL, Combs D, et al. Tuberculosis in children. Pediatr Infect Dis J 1988;7:271-8.
  10. Doerr CA, Starke JR, Ong LT. Clinical and public health aspects of tuberculous meningitis in children. J Pediatr 1995;127:27-33.
  11. Newton RW. Tuberculous meningitis. Arch Dis Child 1994; 70:364-6
  12. Demir K, Okten A, Kaymakoglu S, et al. Tuberculous peritonitis-- reports of 26 cases, detailing diagnostic and therapeutic problems F.Tinsa - Extra-pulmonary Tuberculosis in children 698 Eur J Gastroenterol Hepatol 2001; 13: 581-585
  13. Sochocky S. Tuberculous peritonitis. A review of 100 cases. Am Rev Respir Dis 1967; 95: 398-401
  14. Sanai FM, Bzeizi KI. Systematic review: tuberculous peritonitis-- presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther 2005; 22: 685-700
  15. Lazarus AA, Thilagar B. Abdominal tuberculosis. Dis Mon 2007; 53: 32-38
  16. Dinler G, fiensoy G, Helek D, Kalayc AG. Tuberculous peritonitis in children: Report of nine patients and review of the literature. World J Gastroenterol 2008; 14: 7235-7239
  17. Basu S, Ganguly S, Chandra P K, Basu S. Clinical profile and outcome of abdominal tuberculosis in Indian children. Singapore Med J 2007; 48:900-905
  18. Lin YS, Huang YC, Chang LY, Lin TY, Wong KS. Clinical characteristics of tuberculosis in children in the north of Taiwan. J Microbiol Immunol Infect 2005; 38:41-6.
  19. Erkan T, Cam H, Ozkan HC, et al. Clinical spectrum of acute abdominal pain in Turkish pediatric patients: a prospective study. Pediatr Int 2004; 46:325-9
  20. Al-Saleh S, Al-Arfaj A, Naddaf H, et al. Tuberculous arthritis: a review of 27 cases. Ann Saudi Med 1998; 18: 368-9.
  21. Garrido G, Gomez-Reino JJ, Fernandez-Dapica P, et al. A Review of Peripheral Tuberculous Arthritis. Sem Arthritis Reum 1988; 18: 142-9
  22. González-Gay MA, García-Porrúa C, Cereijo MJ, et al. The clinical spectrum of osteoarticular tuberculosis in non-human immunodeficiency virus patients in a defined area of northwestern Spain (1988-97). Clin Exp Rheumatol 1999; 17: 663-9.
  23. Rodríguez NG, Ruán JI, Seoane JL, et al. Tuberculosis extrapulmonar diseminada con afección cutánea, ganglionar y ósea. An Med Interna 1999; 10: 525-6
  24. Meier JL. Mycobacterial and fungal infections of bone and joints. Curr Opin Rheumatol 1994; 6: 408-14.
  25. Evanchik CC, Davis DE, Harrington TM. Tuberculosis of Peripheral Joints: An Often Missed Diagnosis. J Rheumatol 1986; 13: 187-9.
  26. Moore SL, Rafii M. Imaging of musculoskeletal and spinal tuberculosis. Radiol Clin orth Am 2001;39:329-342
  27. Chen YC, Hsu SW. Tuberculous arthritis mimic arthritis of Sjogren's syndrome: findings from sonography, computed omogaphy and magnetic resonance images. Eur J Radiol 2001;40:23-235
  28. Mabiala-Babela JR, Makosso E, Senga P. Retrospective study of 61 cases of multifocal tuberculosis in children in Brazzaville. Congo Med Trop 2008;68:41-4