Abstract
Tuberculosis is a public health problem that still maintains importance in all developed and developing countries. In childhood tuberculosis, unlike adults, presenting less classical findings and the low rate of detection of the agent by microbiological methods create difficulties in diagnosis. The aim of this study was to evaluate the clinical, laboratory and radiological findings of patients followed up with the diagnosis of tuberculosis disease in our clinic. Thirty-four patients who were followed up with the diagnosis of tuberculosis disease in our clinic on January 2014-December 2019 were included in the study and the files of the patients were reviewed retrospectively. Fifty percent (n:17) of the patients were male, with a median age of diagnosis was 153.5 mos (17-218 months). Thirteen patients were diagnosed with pulmonary, 8 patients with disseminated, 6 patients with gastrointestinal, 6 patients with lymph node and 1 patient with joint tuberculosis. While there were 8 (23.5%) patients with a history of tuberculosis contact, the most common complaints were cough, abdominal pain, weight loss and fever. Eight (23.5%) patients had no pathological findings at the time of admission. While tuberculine skin test was positive in 17 (50%) patients, tubercle bacillus was demonstrated by microbiological methods in seven patients. One patient diagnosed tuberculosis disease by, with a positive response to treatment and exclusion of other diseases. While the treatment was interrupted for a short time due to side effects in four (11.8%) patients, no serious side effects were observed in any of the patients. The diagnosis is made by combining clinical, laboratory and radiological findings, and sometimes patients can be diagnosed with the positive response of the patient to the treatment.
Keywords
References
- 1. Global tuberculosis report. World Health Organization; 2022 https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
- 2. Türkiye’de Verem Savaşı 2020 Raporu, T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, 1205, Ankara, 2021
- 3. Marais BJ, Amanullah F, Gupta A, Becerra MC, Snow K, Ngadaya E, et al. Tuberculosis in children, adolescents, and women. Lancet Respir Med. 2020;8(4):335-337.
- 4. Tüberküloz Tanı ve Tedavi Rehberi; 2019 https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf
- 5. Swaminathan S, Rekha B. Pediatric Tuberculosis: Global Overview and Challenges. Clin Infect Dis. 2010;50:184-94.
- 6. Carvalho ACC, Cardoso CAA, Martire TM, Migliori GB, Sant’Anna CC. Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy. J Bras Pneumol. 2018;44(2):134-44.
- 7. Graham SM, Ahmed T, Amanullah F, Browning R, Cardenas V, Casenghi M, et al. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel. J Infect Dis. 2012;205:199-208
- 8. World Health Organization. Diagnosis of TB in Children. In Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children.; World Health Organization: Geneva, Switzerland, 2018 http://apps.who.int/medicinedocs/documents/s21535en/s21535en.pdf (accessed on 6 November 2018).
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- 10. Mete Yesil A, Yalcin E, Ademhan Turhal D, Emiralioglu N, Dogru D, Ozcelik U, et al. From Diagnosis to Treatment of Pediatric Tuberculosis: Ten Years Experience in a Single Institution. Clin Pediatr (Phila). 2020;59:476-482.
- 11. Aygun D, Akcakaya N, Cokugras H, Camcıoglu Y. Evaluation of Clinical and Laboratory Characteristics of Children with Pulmonary and Extrapulmonary Tuberculosis. Medicina (Kaunas). 2019;55(8):428
- 12. Wu XR, Yin QQ, Jiao AX, Xu BP, Sun L, Jiao WW, et al. Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 2012;130(6):e1433-40.
- 13. Holmberg PJ, Temesgen Z, Banerjee R. Tuberculosis in Children. Pediatr Rev. 2019;40(4):168-178.
- 14. Galli L, Lancella L, Tersigni C, Venturini E, Chiappini E, Bergamini BM, et al. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis. Int J Mol Sci. 2016;17(6):960.
- 15. Zubarioglu T, Bayraktar B, Dalgic N, Sancar M, Cakir E, Togay A, et al. Evaluation of QuantiFERON tuberculosis Gold In-Tube assay for diagnosis of active tuberculosis in children. J Paediatr Child Health. 2020;56(4):581-585.
- 16. Kitai I, Morris SK, Kordy F, Lam R. Diagnosis and management of pediatric tuberculosis in Canada. CMAJ. 2017;189(1):E11-E16.
- 17. World Health Organization. Use of Tuberculosis Interferon-Gamma Release Assays (IGRAs) in Low and Middle-Income Countrzies; WHO Press: Geneva, Switzerland, 2011.
- 18. Kılıç B, Dalgıç N, Bayraktar B, Gencer H. Aşı Komplikasyonu: BCG-itis. J Pediatr Inf. 2011; 5:148-52.
- 19. BCG Vaccination, WHO. https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/vaccines-quality/bcg
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- 21. Mangtani P, Abubakar I, Ariti C, Beynon R, Pimpin L, Fine PE, et al. Protection by BCG vaccine against tuberculosis: a systematic review of randomized controlled trials. Clin Infect Dis. 2014;58(4):470-80.
- 22. Donald PR. Antituberculosis drug-induced hepatotoxicity in children. Pediatr Rep. 2011;3(2):e16.
Abstract
Tüberküloz gelişmiş ve gelişmekte olan tüm ülkelerde halen önemini koruyan bir halk sağlığı sorunudur. Çocukluk çağı tüberkülozunda erişkinden farklı olarak klasik bulguların daha az görülmesi ve mikrobiyolojik yöntemlerle etkenin gösterilme oranının düşük olması tanıdaki zorlukları oluşturur. Bu çalışma ile kliniğimizde tüberküloz hastalığı tanısı ile takip edilen hastaların klinik, laboratuvar ve radyolojik bulgularının değerlendirilmesi amaçlanmıştır. Çalışmaya kliniğimizde Ocak 2014-Aralık 2019 tarihleri arasında tüberküloz hastalığı tanısı ile izlenen 34 hasta dahil edilmiş olup hastaların dosyaları retrospektif olarak incelenmiştir. Hastaların %50’si (n:17) erkek olup tanı yaşı ortancası 153.5 aydır (aralık 17-218 ay). On üç hasta pulmoner, 8 hasta dissemine, 6 hasta gastrointestinal tüberküloz tanısı alırken; 6 hasta lenf nodu, 1 hasta eklem tüberkülozu tanısı almıştır. Tüberküloz temas öyküsü 8 (%23.5) hastada bulunmakta iken en sık başvuru şikayeti öksürük, karın ağrısı, kilo kaybı ve ateşti. Sekiz (%23.5) hastada başvuru sırasında patolojik muayene bulgusu saptanmamıştır. On yedi (%50) hastada tüberkülin deri testi pozitifliği mevcut iken yedi hastada tüberküloz basili mikrobiyolojik yöntemlerle gösterilmiştir. Bir hastada tedaviye verdiği olumlu yanıt ve diğer hastalıkların dışlanması ile tüberküloz hastalığı tanısı konulmuştur. Dört (%11.8) hastada yan etki nedeniyle tedaviye kısa süreli ara verilirken hiçbir hastada ciddi yan etki gözlenmemiştir. Tanı klinik, laboratuvar ve radyolojik bulguların bir araya getirilmesi ile konulmakta olup, kimi zaman hastanın tedaviye verdiği olumlu cevap ile hastalar tanı alabilmektedir.
Keywords
References
- 1. Global tuberculosis report. World Health Organization; 2022 https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
- 2. Türkiye’de Verem Savaşı 2020 Raporu, T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, 1205, Ankara, 2021
- 3. Marais BJ, Amanullah F, Gupta A, Becerra MC, Snow K, Ngadaya E, et al. Tuberculosis in children, adolescents, and women. Lancet Respir Med. 2020;8(4):335-337.
- 4. Tüberküloz Tanı ve Tedavi Rehberi; 2019 https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf
- 5. Swaminathan S, Rekha B. Pediatric Tuberculosis: Global Overview and Challenges. Clin Infect Dis. 2010;50:184-94.
- 6. Carvalho ACC, Cardoso CAA, Martire TM, Migliori GB, Sant’Anna CC. Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy. J Bras Pneumol. 2018;44(2):134-44.
- 7. Graham SM, Ahmed T, Amanullah F, Browning R, Cardenas V, Casenghi M, et al. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel. J Infect Dis. 2012;205:199-208
- 8. World Health Organization. Diagnosis of TB in Children. In Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children.; World Health Organization: Geneva, Switzerland, 2018 http://apps.who.int/medicinedocs/documents/s21535en/s21535en.pdf (accessed on 6 November 2018).
- 9. Starke JR. Tuberculosis. In: Samuel L, Gershon AA, Hotez PJ, and Katz SL, eds. Krugman’s Infectious Diseases of Children. 11th ed. Philadelphia, PA: Mosby; 2004:731-767
- 10. Mete Yesil A, Yalcin E, Ademhan Turhal D, Emiralioglu N, Dogru D, Ozcelik U, et al. From Diagnosis to Treatment of Pediatric Tuberculosis: Ten Years Experience in a Single Institution. Clin Pediatr (Phila). 2020;59:476-482.
- 11. Aygun D, Akcakaya N, Cokugras H, Camcıoglu Y. Evaluation of Clinical and Laboratory Characteristics of Children with Pulmonary and Extrapulmonary Tuberculosis. Medicina (Kaunas). 2019;55(8):428
- 12. Wu XR, Yin QQ, Jiao AX, Xu BP, Sun L, Jiao WW, et al. Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 2012;130(6):e1433-40.
- 13. Holmberg PJ, Temesgen Z, Banerjee R. Tuberculosis in Children. Pediatr Rev. 2019;40(4):168-178.
- 14. Galli L, Lancella L, Tersigni C, Venturini E, Chiappini E, Bergamini BM, et al. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis. Int J Mol Sci. 2016;17(6):960.
- 15. Zubarioglu T, Bayraktar B, Dalgic N, Sancar M, Cakir E, Togay A, et al. Evaluation of QuantiFERON tuberculosis Gold In-Tube assay for diagnosis of active tuberculosis in children. J Paediatr Child Health. 2020;56(4):581-585.
- 16. Kitai I, Morris SK, Kordy F, Lam R. Diagnosis and management of pediatric tuberculosis in Canada. CMAJ. 2017;189(1):E11-E16.
- 17. World Health Organization. Use of Tuberculosis Interferon-Gamma Release Assays (IGRAs) in Low and Middle-Income Countrzies; WHO Press: Geneva, Switzerland, 2011.
- 18. Kılıç B, Dalgıç N, Bayraktar B, Gencer H. Aşı Komplikasyonu: BCG-itis. J Pediatr Inf. 2011; 5:148-52.
- 19. BCG Vaccination, WHO. https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/vaccines-quality/bcg
- 20. Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006;367:1173-1180.
- 21. Mangtani P, Abubakar I, Ariti C, Beynon R, Pimpin L, Fine PE, et al. Protection by BCG vaccine against tuberculosis: a systematic review of randomized controlled trials. Clin Infect Dis. 2014;58(4):470-80.
- 22. Donald PR. Antituberculosis drug-induced hepatotoxicity in children. Pediatr Rep. 2011;3(2):e16.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | ORİJİNAL MAKALE |
| Authors | |
| Publication Date | September 27, 2023 |
| Published in Issue | Year 2023 Volume: 45 Issue: 5 |