Extra-pulmonary tuberculosis in children

Maltezou, Helen C.; Spyridis, P.; Kafetzis, Dimitrios

doi:10.1136/adc.83.4.342

Cited by 103 publications

(91 citation statements)

References 12 publications

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“…Furthermore, male gender was predominant in reports of extrapulmonary tuberculosis series including adult and pediatric cases (12,13). Among 115 children with abdominal tuberculosis from India and 102 children with extrapulmonary tuberculosis from Greece, most of the cases were males (14,15). In this study 19 of 35 patients were male (54.3%).…”

Section: Discussionmentioning

confidence: 99%

Assessment of 35 children with abdominal tuberculosis

Kılıç

Somer²,

Törün³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To contribute to the diagnosis and treatment of pediatric abdominal tuberculosis cases by assessing the clinical, laboratory, and radiological features of patients who presented at our clinic and were diagnosed with abdominal tuberculosis. Materials and Methods: Clinical, laboratory, and radiological features were reviewed retrospectively for 35 patients diagnosed with abdominal tuberculosis and followed up at the Pediatric Infectious Diseases Clinic between January 1987 and August 2012. Results: The study group included 16 female (45.7%) and 19 male (54.3%) patients with an age range of 6 months to 16 years (mean: 9.77±4.36 years). Twenty-nine patients were diagnosed with tuberculosis peritonitis, five patients with intestinal tuberculosis, and one patient with pelvic tuberculosis. The most common signs and symptoms were ascites, abdominal pain, abdominal distention, weight loss, and fever. Mean duration of the complaints was 109 days (range: 10 days to 3 years). Conclusion: Abdominal tuberculosis is a disease with an insidious course without disease-specific clinical and laboratory signs. When the disease is suspected, laparoscopy or laparotomy could be helpful in diagnosis. Employing ultrasound and computed tomography signs, abdominal tuberculosis should be included in differential diagnoses in regions with a high incidence of tuberculosis when there is abdominal pain, weight loss, ascites, history of contact with individuals with tuberculosis, and positive tuberculin skin test when patients have not been Bacillus Calmette Guerin BCG vaccinated.

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Section: Discussionmentioning

confidence: 99%

Assessment of 35 children with abdominal tuberculosis

Kılıç

Somer²,

Törün³

et al. 2015

Turk J Gastroenterol

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“…18 Maltezou and his colleagues found the lymph node was the most common site of EPTB in children and EPTB constituted 9% of all cases with TB Lymph node involvement in EPTB was correlated with HIV coinfection, female gender, young age and Asian race. 23,24 In our study lymph node involvement was the most common site (29.411%) and second most common site is gastrointestinal (24.04%). Pleural involvement was in the third place.…”

Section: Discussionmentioning

confidence: 98%

Site predilection of extrapulmonary tuberculosis: study from a tertiary care centre

et al. 2015

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“…Además, esta y el drenaje por pericardiotomía son procedimientos menores que el cirujano puede practicar con anestesia local o general, y cuya sensibilidad diagnóstica para la pericarditis tuberculosa está en el rango de 10 a 64 % (10,(17)(18)(19)(20). Por otro lado, con las tinciones de hematoxilina y eosina, Ziehl-Neelsen y auramina, se detectan 87 % de los granulomas caseificantes, aunque en pacientes con HIV la detección puede reducirse a 50 % debido a que en los estadios avanzados de la enfermedad no se forman granulomas (14,15).…”

Section: Discussionunclassified

“…La detección de lisozima pericárdica también se ha utilizado como prueba indirecta, con una sensibilidad y una especificidad de 100 y 91,17 %, respectivamente (10). En los países en desarrollo, donde la tuberculosis es endémica, la prueba cutánea de la tuberculina tiene un valor limitado debido a la alta prevalencia de tuberculosis primaria y a la inmunización masiva con BCG; se considera que la reacción cutánea es positiva cuando presenta una induración de más de 10 mm y, acentuadamente positiva, cuando es de más de 15 mm, con excoriación de la piel o sin ella (10,(17)(18)(19)(20).…”

Section: Discussionunclassified

Pericarditis tuberculosa: reporte de caso

Echeverri

Matta

2014

biomedica

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Institución donde se llevó a cabo la investigación: Corporación Comfenalco Valle-Universidad Libre La tuberculosis sigue siendo una de las principales causas de morbilidad y mortalidad en el mundo. Su forma extrapulmonar representa hasta el 20 % de los casos. Se ha estimado que el compromiso pericárdico en esta enfermedad se presenta en 1 a 4 % de los pacientes diagnosticados. Su mortalidad alcanza el 90 % si no se diagnostica y se trata adecuadamente; este porcentaje se reduce a 12 % con el diagnóstico y el tratamiento oportunos. Se presenta el caso de una paciente de 55 años, hospitalizada durante dos semanas con síntomas constitucionales, fiebre intermitente, tos seca, dolor pleurítico y algunos síntomas de falla cardiaca. En los estudios de imaginología (radiografía y ecografía de tórax) se encontró derrame pleural bilateral de 300 ml en el lado derecho y de 1.000 ml en el izquierdo, así como derrame pericárdico de 500 ml. Las baciloscopias directas de los líquidos pleural y pericárdico, así como en esputo, fueron negativas, al igual que la proteína C reactiva (PCR); sin embargo, el cultivo del líquido pericárdico en medio de Löwenstein-Jensen fue positivo para Mycobacterium tuberculosis. El resultado de la prueba de PPD (Purified Protein Derivative) fue de 23 mm; una vez iniciado el tratamiento conjugado con isoniacida, rifampicina, etambutol y pirazinamida, se presentó una mejoría rápida del cuadro clínico que persistió hasta que se le dio de alta. La pericarditis tuberculosa puede considerarse como una manifestación infrecuente de la tuberculosis, con una morbilidad elevada y una mortalidad considerable, cuya probabilidad disminuye si hay un diagnóstico oportuno y se instaura un tratamiento efectivo temprano. Aunque se han sugerido varios criterios diagnósticos para la pericarditis tuberculosa, su diagnóstico definitivo puede implicar varios desafíos técnicos. Tuberculous pericarditisTuberculosis remains a major cause of morbidity and mortality worldwide, and the extrapulmonary presentation represents up to 20% of this disease. The pericardial compromise of this disease has been estimated between 1% and 4% of diagnosed patients. This presentation may have a mortality rate as high as 90% without proper treatment and diagnosis, dropping to 12% with timely diagnosis and treatment. We present the case of a 55 year-old female patient hospitalized for two weeks with constitutional symptoms, intermittent fever, dry cough, pleuritic pain and some symptoms of heart failure. The imaging studies (chest x-rays and ultrasound), revealed bilateral pleural effusion: 300 cc on the right side, 1,000 cc on the left side, and 500 cc of pericardial effusion. Direct bacilloscopy of the pleural fluid, the pericardial fluid and the sputum were negative, as well as the C-reactive protein (CRP); however, the Löwenstein-Jensen culture of the pericardial fluid was positive for Mycobacterium tuberculosis. The result of the purified protein derivative (PPD) test showed a 23 mm swelling, and after quadruple therapy her clinical condi...

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Extra-pulmonary tuberculosis in children

Cited by 103 publications

References 12 publications

Assessment of 35 children with abdominal tuberculosis

Assessment of 35 children with abdominal tuberculosis

Site predilection of extrapulmonary tuberculosis: study from a tertiary care centre

Pericarditis tuberculosa: reporte de caso

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