Childhood Intra-thoracic Tuberculosis

Abstract

Tuberculosis (TB) has affected human kind for a very long time; archeological findings describe suggestive spinal changes in Neolithic man and conclusive evidence of tuberculous bone lesions have been found in mummified remains from Egypt, dating back to 3400 BC (Keers, 1978;Rubin, 1995). Hippocrates (460-377 BC) introduced the ancient Greek term for TB, phthisis, which became better known as consumption in the English world (Keers, 1978;Rubin, 1995). Although TB is an ancient disease it remains a major public health challenge. In fact, fuelled by poverty and rapid urbanization in developing countries, together with immune compromise resulting from human immunodeficiency virus (HIV) infection and emerging drug resistance, TB affects and kills more people today than ever before. The gravity of the situation is demonstrated by the fact that the TB epidemic continues to escalate, especially in sub-Saharan Africa, despite the declaration of a global TB emergency by the World Health Organization (WHO) in 1993.TB is caused by Mycobacterium tuberculosis (M. tuberculosis), which was first identified by Robert Koch (1843Koch ( -1910 in 1882. The diagnostic techniques pioneered by Koch have remained virtually unchanged since then; sputum smear microscopy remains the only diagnostic test available in most resource-limited settings. Interestingly, shortly after Robert Koch identified M. tuberculosis as the infectious agent that causes TB, it became apparent that infection with M. tuberculosis was far more common than actual TB disease. This form of latent TB infection is recognized by the presence of a positive tuberculin skin test (TST) in healthy asymptomatic individuals. A British Medical Research Council survey conducted in London in 1950 showed that 60-70% of individuals had a positive TST (were infected with M. tuberculosis) by 20 years of age (Bentley et al., 1954); an infection rate similar to those reported in TB-endemic areas today (Obihara

High sensitivity C-reactive protein level in various manifestations of tuberculosis in children

“…In contrast, a previous study described a high risk of disseminated TB in the <2 years of age group (2-5%), especially for infants (10-20%), while the >10 years of age group had the lowest risk (<0.5%). 12 Primary infection before 2 years of age often progresses to serious illness within the first 12 Significant (P<0.05); ¥ Chi-square; £ Fisher's exact test Significant (P<0.05); a Mann-Whitney; b Kruskal-Wallis; AFB=acid-fast bacillus months without significant symptoms. 12 There were no significant differences in hs-CRP levels according to patient age.…”

“…12 Primary infection before 2 years of age often progresses to serious illness within the first 12 Significant (P<0.05); ¥ Chi-square; £ Fisher's exact test Significant (P<0.05); a Mann-Whitney; b Kruskal-Wallis; AFB=acid-fast bacillus months without significant symptoms. 12 There were no significant differences in hs-CRP levels according to patient age.…”

High burden of viral respiratory co-infections in a cohort of children with suspected pulmonary tuberculosis

“…An estimated 1 million children < 15 years develop tuberculosis (TB) every year [1]. Pulmonary TB (PTB) contributes to approximately 75% of the TB disease burden in children, and is difficult to confirm given the paucibacillary nature of the disease and challenges in obtaining good quality respiratory samples in young children [2]. Moreover, the clinical diagnosis of PTB in children is frequently complicated by non-specific clinical presentations, which overlap with other common respiratory illnesses [3].…”