Tuberculosis Exposure, Infection and Disease Among Children with Medical Comorbidities

Cruz, Andrea T.; Merchant, Omar; Zafar, Affan; Starke, Jeffrey R.

doi:10.1097/inf.0000000000000343

Cited by 7 publications

(2 citation statements)

References 7 publications

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“…Specimen collection should be performed before TB treatment. The specimen collection strategy should include collecting at least two samples (preferably of different specimen types), ensuring high -quality and -quantity of each sample and considering pooling of samples if necessary [47–50]. Early morning respiratory specimens generally have the best yield.…”

Section: Step 2: Identify Findings Supportive Of Tb As the Etiologymentioning

confidence: 99%

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

Roya-Pabón

Pérez-Vélez

2016

Pneumonia

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The accurate diagnosis of tuberculosis (TB) in children remains challenging. A myriad of common childhood diseases can present with similar symptoms and signs, and differentiating between exposure and infection, as well as infection and disease can be problematic. The paucibacillary nature of childhood TB complicates bacteriological confirmation and specimen collection is difficult. In most instances intrathoracic TB remains a clinical diagnosis. TB infection and disease represent a dynamic continuum from TB exposure with/without infection, to subclinical/incipient disease, to non-severe and severe disease. The clinical spectrum of intrathoracic TB in children is broad, and the classification of clinical, radiological, endoscopic, and laboratory findings into recognized clinical syndromes allows a more refined diagnostic approach in order to minimize both under- and over-diagnosis. Bacteriological confirmation can be improved significantly by collecting multiple, high-quality specimens from the most appropriate source. Mycobacterial testing should include traditional smear microscopy and culture, as well as nucleic acid amplification testing. A systematic approach to the child with recent exposure to TB, or with clinical and radiological findings compatible with this diagnosis, should allow pragmatic classification as TB exposure, infection, or disease to facilitate timely and appropriate management. It is important to also assess risk factors for TB disease progression and to undertake follow-up evaluations to monitor treatment response and ongoing evidence supporting a TB, or alternative, diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s41479-016-0023-9) contains supplementary material, which is available to authorized users.

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Section: Step 2: Identify Findings Supportive Of Tb As the Etiologymentioning

confidence: 99%

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

Roya-Pabón

Pérez-Vélez

2016

Pneumonia

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“…Additional risk factors include exposure to a person with active pulmonary tuberculosis that has not been treated, travel to endemic regions, or medical conditions that increase the risk of progression to disease, such as immunosuppressive therapy (87). A review of tuberculosis in children with comorbidities demonstrates the importance of screening and the increased mortality associated with tuberculosis in this high‐risk population (88).…”

Section: Summary Of Findings Regarding Infection and Anti‐tnfα Therap...mentioning

confidence: 99%

NASPGHAN Clinical Report

Ardura

Toussi

Siegel

et al. 2016

J. pediatr. gastroenterol. nutr.

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Children and adolescents with inflammatory bowel disease (IBD) receiving therapy with tumor necrosis factor α inhibitors (anti-TNFα) pose a unique challenge to health care providers in regard to the associated risk of infection. Published experience in adult populations with distinct autoinflammatory and autoimmune diseases treated with anti-TNFα therapies demonstrates an increased risk of serious infections with intracellular bacteria, mycobacteria, fungi, and some viruses; however, there is a paucity of robust pediatric data. With a rising incidence of pediatric IBD and increasing use of biologic therapies, heightened knowledge and awareness of infections in this population is important for primary care pediatricians, pediatric gastroenterologists, and infectious disease (ID) physicians. This clinical report is the result of a consensus review performed by pediatric ID and gastroenterology physicians detailing relevant published literature regarding infections in pediatric patients with IBD receiving anti-TNFα therapies. The objective of this document is to provide comprehensive information for prevention, surveillance, and diagnosis of infections based on current knowledge, until additional pediatric data are available to inform evidence-based recommendations.

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Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres

et al. 2017

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despite the low number of patients included in our study, SCA does not seem to be a risk factor for severe TB. What is Known: • Tuberculosis (TB) remains a global health problem particularly in developing countries, and Sickle cell anaemia (SCA) is currently one of the most common genetic diseases in the world that mainly affects African populations. • Very few data are available on TB in SCA patients. What is New: • The features of TB in children with SCA seem to be comparable to those expected in general population, with favourable outcomes in response to standard treatment. • Monitoring the dosage of anti-TB treatments could be of interest because of the possible impact of SCA on drug metabolism.

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Tuberculosis Exposure, Infection and Disease Among Children with Medical Comorbidities

Cited by 7 publications

References 7 publications

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

NASPGHAN Clinical Report

Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres

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