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The clinical records of fourteen children discharged with the diagnosis of tuberculous (TB) meningitis from a metropolitan hospital at Santiago, Chile, were reviewed: Nine patients (64%) were under 5 years, but all were older than 12 month of age, eight (57%) had positive history of exposure to TB, even though this information was not always easy to obtain and five (36%) had BCG scars. Mycobacterium tuberculosis was isolated from the cerebrospinal fluid of 5 patients (36%). Other four patients had miliary spread of the disease associated to the meningeal infection. The most frecuent laboratory finding was low chloride concentration in the cerebrospinal fluid (CSF). Secuelae occurred in 11 patients (79%), consisting in hidrocephalus in 7. A clear correlation was observed between secuelae and the amount of time elapsed from admission to the begining of the specific antibacterial therapy. BCG scar does not exclude the diagnosis of TB meningitis. In patients presenting with meningoencephalic symptoms, motor involvement, cranial nerve palsies and low CSF chloride levels the diagnosis of TB meningitis must be considered. (

Clinical forms of tuberculosis in a Chilean children's hospital, 1989-2005In Chilean children the incidence of tuberculosis (TB) is low: 2.3/100.000 in younger than 15 years old (2005). This fact may explain that TB diagnosis is sometimes difficult to do in pediatric patients. Our aim was to describe the clinical forms of presentation of TB in children's hospital patients with confirmed TB diagnosis between the years 1989-2005. We carried out this retrospective analysis in 49 patients younger than 15 years old (mean: 5.8 years.); 65.5% of them had a history of contact with an active tuberculosis case. Twenty nine (59.1%) patients were diagnosed as pulmonary TB, 19 of them (65.5%) as primary pulmonary TB and the remainder 10 as post-primary pulmonary TB. Out of the 20 patients with extrapulmonary TB, adenitis was the most frequent (n = 8) followed by pleural effusion (n = 7). Chest x-ray was normal in 10 out of the 49 patients. Major x-ray pathological findings were: primary pulmonary TB 38.7% (n = 19), pleural effusion 14.3% (n = 7), and parenchyma air-space consolidation 10.2% (n = 5). We expect this study would contribute to make a much earlier diagnosis and treatment of TB in children.

Valor del recuento de Eosinofilos en secrecion nasal en el diagn6stico diferencial de los cuadros bronquiales obstructives del nino.

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