Qualitative evaluation of Tuberculin test responses in childhood Tuberculosis

Akhila, K.; Mahadevan, Subramanian; Adhisivam, B

doi:10.1007/s12098-007-0114-y

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…However, the diagnostic utility of skin testing for CNS tuberculosis is highly variable. Rates for children vary between 30% and 65% [12, 13], although individuals in high tuberculosis prevalence areas are more likely to have positive test results with an unrelated illness [14]. It is interesting that cerebrospinal fluid (CSF) analysis was not done for our patient, because it was refused by the parents.…”

Section: Discussionmentioning

confidence: 99%

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

et al. 2017

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BackgroundTuberculosis remains a public health problem in developing countries and is associated with lethal central nervous system complications. Intracranial tuberculomas occur in 13% of children with neurotuberculosis. Patients with trisomy 21 have an increased risk for stroke, which usually stems from cardiovascular defects.Case presentationWe report a case of a 12-year-old Sudanese boy with trisomy 21 who was presented to our hospital with focal convulsions and right-sided weakness. The results of neuroimaging and histopathological examinations were consistent with cerebral tuberculoma. The patient had a good initial response to antituberculosis drugs and steroids. To the best of our knowledge, this is the first case report of multiple brain tuberculomas described in a child with trisomy 21.ConclusionsPatients with trisomy 21 have an increased risk for stroke. Our patient had an exceptional case of stroke caused by tuberculoma. The present case emphasizes the need to consider tuberculomas in the differential diagnosis of children with neurological symptoms living in areas of high tuberculosis incidence.

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Section: Discussionmentioning

confidence: 99%

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

et al. 2017

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“…For this reason alone, the clinical diagnosis is perhaps suspected and made more frequently than elsewhere. High infection rates in early childhood render tuberculin testing of limited help, as in case 1 14. Early institution of ATT as a therapeutic trial in itself is helpful in suspected secondary tuberculosis at sites where confirmatory microbiologic or histopathologic sampling is difficult 15, 16, or such confirmation is not forthcoming despite sampling 17.…”

Section: Discussionmentioning

confidence: 99%

Langerhans cell histiocytosis masquerading as tuberculosis: A diagnostic dilemma resulting in inappropriate anti‐tubercular therapy

Sharma

Dhingra

Sural

et al. 2009

Pediatric Blood & Cancer

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Langerhans cell histiocytosis is known to mimic many other conditions. We present two patients where anti-tubercular therapy was instituted when clinical and radiological features suggested tuberculosis. The correct diagnosis of histiocytosis was reached only on further work-up including immunohistochemistry following un-responsiveness to treatment. In retrospect it was felt that an inordinately high index of suspicion for tuberculosis, clinical and radiological overlap between the two entities, an urgency to start empirical therapy in a rapidly deteriorating patient and pathological similarities between epithelioid histiocytes and pathologic Langerhans cells led to the diagnostic and therapeutic errors.

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“…The evidence of TB infection or disease outside the CNS can significantly increase the probability or possibility that a child with cerebral signs and symptoms can have TB meningitis. However, a great number of patients, particularly when HIV negative, will present with normal chest radiography or negative tuberculin skin testing (12). Moreover, particularly in high TB prevalence areas, a positive skin test with an unrelated illness has been frequently documented.…”

Section: Wwwrespircasecommentioning

confidence: 99%

Tuberculous Meningitis in Two-Year-Old Male Boy: Evidence of Recent Transmission from Mother to Baby

Patil¹,

Nagargoje²,

Choudhary³

2017

Respir Case Rep

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Tuberculous (TB) meningitis is the commonest infectious disease of central nervous system in pediatric and geriatric cases. Tuberculosis can be prevented in children by diagnosing and treating cases of active TB amongst adults, as pediatric cases always acquire it passively from household contact of adults suffering from TB as disease in adults is multibacillary. Although significant data is available for the prevention of childhood extra-pulmonary and disseminated TB, offering them Bacillus Calmette-Guerin (BCG) vaccination, it is still not routinely offered during vaccination. In this case report, a two-year child with a history of failure to thrive and constitutional symptoms diagnosed with disseminated extra-pulmonary TB presenting as TB meningitis with a history of contact with the mother suffering from active sputum positive pulmonary TB receiving anti-TB treatment. In conclusion, we recommend BCG vaccination to all newborns, and tuberculin skin testing and isoniazid prophylaxis to the contact of adults with sputum positive pulmonary TB cases in India. ÖzetTüberküloz menenjit, pediatrik ve geriatrik olgularda en sık görülen santral sinir sistemi enfeksiyonudur. Pediatrik olgular, basil yayan erişkin tüberküloz hastaları ile yakın temas sonucu hasta oldukları için aktif erişkin tüberküloz olgularının tanı ve tedavilerinin yapılması ile çocukların bu hastalıktan korunması mümkün olabilir. Çocukluk çağında yapılan BCG aşılanması ile akciğer dışı ve yaygın tüberkülozdan çocukların korunduklarına dair anlamlı veriler bulunmasına rağmen, halen aşılama rutin olarak yapılma-maktadır. Bu olgu sunumunda, gelişme geriliği ve konstitüsyonel semptomları olan ve yaygın akciğer dışı tüberkülozun menenjit formunda ortaya çıktığı, iki yaşındaki çocuk sunulmuştur. Çocuğun tüberküloz yakın teması olarak annesinin yayma pozitif akciğer tüberkülozu olduğu ve antitüberküloz tedavi aldığı belirlenmiştir. Sonuç olarak, Hindistan'da, tüm yeni doğanlara BCG aşısı yapılmasını ve yayma pozitif akciğer tüberkülozlu erişkinlerin temaslılarının tüber-külin testinin yapılarak isoniyazid proflaksisine alın-masını tavsiye ediyoruz.Anahtar Sözcükler: Tüberküloz menenjit, BCG aşısı, isoniyazid, tüberkülin deri testi, anneden çocuğa bulaşma.

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Qualitative evaluation of Tuberculin test responses in childhood Tuberculosis

Abstract: Qualitative TST responses are non-homogeneous among the various clinical types of childhood tuberculosis. They are not a correlate of protective immunity with little or no prognostic significance.

Cited by 7 publications

References 2 publications

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

Langerhans cell histiocytosis masquerading as tuberculosis: A diagnostic dilemma resulting in inappropriate anti‐tubercular therapy

Tuberculous Meningitis in Two-Year-Old Male Boy: Evidence of Recent Transmission from Mother to Baby

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