Clinical manifestation and outcome of tuberculosis in children with acquired immunodeficiency syndrome
| Autor: | Phillip Steiner, Madu Rao, Siu Pun Chan, Jeffrey Birnbaum |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Male
Microbiology (medical) Pediatrics medicine.medical_specialty Tuberculosis Adolescent Antitubercular Agents Microbial Sensitivity Tests Disease Tachypnea Acquired immunodeficiency syndrome (AIDS) Immunopathology Tuberculosis Multidrug-Resistant Isoniazid medicine Humans Capreomycin Child Sida Antibiotics Antitubercular Tuberculosis Pulmonary Acquired Immunodeficiency Syndrome AIDS-Related Opportunistic Infections biology business.industry Infant medicine.disease biology.organism_classification Pyrazinamide Surgery Infectious Diseases El Niño Child Preschool Pediatrics Perinatology and Child Health Female Viral disease Rifampin medicine.symptom business Ethambutol |
| Zdroj: | The Pediatric Infectious Disease Journal. 15:443-447 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/00006454-199605000-00012 |
| Popis: | Background Atypical clinical manifestations and rapid progression of tuberculous disease (TB) are well-recognized in adults with the acquired immunodeficiency syndrome (AIDS). There are few reports of children with AIDS and TB. We report the manifestations, clinical course and outcome of 12 pediatric patients with AIDS and TB. Methods The charts of all children admitted to our institution, from 1989 through 1994, with the diagnoses of AIDS and culture-proved TB were reviewed. Results Twelve children between the ages of 2 months and 13 years fit the criteria. The mean time between the diagnosis of AIDS and TB was 20 months. The most frequent presenting symptoms were fever (75%) and tachypnea (33%). All had negative Mantoux tests (5 tuberculin units of purified protein derivative). Extrapulmonary TB was present in 3 (25%). A source case was identified for 4 (33%). Previous pulmonary disease was present in 7 (58%). Chest roentgenograms were abnormal in 11 (91%), with diffuse interstitial infiltration the most common finding. Susceptibility tests were performed on 10 strains, 3 of which were resistant to 1 or more antituberculosis drugs. Three patients (25%) died of TB, 1 of whom was appropriately treated with antituberculosis drugs but had a strain resistant to isoniazid and rifampin. Conclusion Children with AIDS and TB most frequently present with atypical manifestations of TB. A high index of suspicion is needed to correctly diagnose TB in this group of children. Early diagnosis is important because most respond well when treated appropriately. |
| Databáze: | OpenAIRE |
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