Alert sign and symptoms for the early diagnosis of pulmonary tuberculosis: analysis of patients followed by a tertiary pediatric hospital

Abstract

Background Intercepting earlier suspected TB (Tuberculosis) cases clinically is necessary to reduce TB incidence, so we described signs and symptoms of retrospective cases of pulmonary TB and tried to evaluate which could be early warning signs. Methods We conducted a retrospective descriptive study of pulmonary TB cases in children in years 2005–2017; in years 2018–2020 we conducted a cohort prospective study enrolling patients < 18 years accessed to Emergency Department (ED) with signs/symptoms suggestive of pulmonary TB. Results In the retrospective analysis, 226 patients with pulmonary TB were studied. The most frequently described items were contact history (53.5%) and having parents from countries at risk (60.2%). Cough was referred in 49.5% of patients at onset, fever in 46%; these symptoms were persistent (lasting ≥ 10 days) in about 20%. Lymphadenopathy is described in 15.9%. The prospective study enrolled 85 patients of whom 14 (16.5%) were confirmed to be TB patients and 71 (83.5%) were non-TB cases. Lymphadenopathy and contact history were the most correlated variables. Fever and cough lasting ≥ 10 days were less frequently described in TB cases compared to non-TB patients (p < 0.05). Conclusions In low TB endemic countries, pulmonary TB at onset is characterized by different symptoms, i.e. persistent fever and cough are less described, while more relevant are contact history and lymphadenopathy. It was not possible to create a score because signs/symptoms usually suggestive of pulmonary TB (considered in the questionnaire) were not significant risk factors in our reality, a low TB country.

Advancing tuberculosis management: the role of predictive, preventive, and personalized medicine

“…Coughing is another common symptom of pulmonary TB ( Farina et al, 2022 ). AI algorithms can undergo training to analyze audio recordings of cough sounds and recognize patterns that are suggestive of TB infection.…”

Reporte de caso clínico y revisión de la literatura: tuberculosis pulmonar asociado a neumonía por pseudomonas aeruginosa.

“…Generalmente en la tuberculosis activa la persona enferma tiende a presentar sintomatología como tos con una duración mayor a dos semanas (21), la fiebre que tiene una duración mayor a los 10 días, muy frecuente y tiene como característica presentarse al final de la tarde, así mismo síntomas como malestar general, astenia, cefalea, sudores nocturnos, pérdida de peso hasta el 75 % de los casos de tuberculosis pulmonar, el dolor torácico que es localizado se manifiesta cuando hay afectación pleurítica y la linfadenopatía, que no siempre es un síntoma que hace sospechar de TB (21) (22).…”