Proposed management of childhood tuberculosis in low-incidence countries

Life-threatening disseminated tuberculosis developed in a 17-year-old girl who was treated with the TNF-α blocker adalimumab for refractory SAPHO syndrome. The patient presented to the emergency department with dyspnea and somnolence and within 2 h developed the clinical picture of a septic shock. In addition to this unusual presentation, she showed a complicated course with increasing cerebral granuloma formation in spite of adequate antimycobacterial treatment. Immune reconstitution after discontinuation of TNF blockade may contribute to this "paradoxical reaction." Possible implications for screening, diagnosis, and treatment of tuberculosis in children and adolescents receiving anti-TNF treatment are discussed.

show abstract

“…2) gave decisive clues. The TST is negative in more than 40% of cases and therefore often misleading [17].…”

Section: Discussionmentioning

confidence: 99%

Life-threatening disseminated tuberculosis as a complication of TNF-α blockade in an adolescent

et al. 2011

Self Cite

View full text Add to dashboard Cite

show abstract

“…The most important approach in the fight against the disease is determination, identification and treatment of the source cases, as well as BCG vaccination soon after birth 20,21. In our country, chest X-ray examination and TST are done in all members of the household of an adult index case.…”

Section: Discussionmentioning

confidence: 99%

Description of Pediatric Tuberculosis Evaluated in a Referral Center in Istanbul Turkey

et al. 2012

View full text Add to dashboard Cite

PurposeDiagnosis of tuberculosis (TB) in children is more challenging than in adults. This study aimed to describe demographical, clinical and laboratory findings of children diagnosed with tuberculosis in Turkey, including the issues of contact tracing, culture positivity and forms of the disease.Materials and MethodsClinical and laboratory data of 51 children with a mean age of 8.0±4.6 years who were diagnosed with TB were retrospectively reviewed. Main diagnostic tools included tuberculin skin test, chest X-ray, sputum/gastric aspirate culture with sensitivity testing, and direct microscopy for acid-fast bacilli on available samples. Clinical characteristics and outcomes of the patients were examined.ResultsThirty-six (70.6%) children were diagnosed with intra-thoracic and 15 (29.4%) with extra-thoracic tuberculosis. Twenty-eight of the patients had a positive Bacillus Calmette-Guérin vaccine scar (28/51, 54.9%) and 23/51 (45.1%) had a positive tuberculin skin test. An adult TB contact was identified in 27 (52.9%) of the cases. On direct microscopy, acid-fast bacilli were found in nine (17.6%) patients and positive culture for Mycobacterium tuberculosis was found in 19 (37.3%). Drug resistance to isoniazid was detected in four (7.8%). One patient with nephrotic syndrome and miliary tuberculosis died during follow-up. All other patients responded well to the treatment.ConclusionFocusing on active contact tracing among all household contacts of tuberculous cases may be helpful in early identification and controlling childhood disease, even in regions with low disease prevalence. Adopting a suspicious and proactive approach in this particular age group is warranted.

show abstract

“…The inclusion of tuberculosis in the differential diagnosis of unclear pulmonary and extrapulmonary disease remains important, and tuberculosis has to be managed according to international standards [7]. Although, childhood tuberculosis represents an important part of the disease burden, yet its diagnosis remains challenging [9].…”

Section: Discussionmentioning

confidence: 99%

Primary tooth abscess caused by Mycobacterium bovis in an immunocompetent child

Maragou

Theologie-Lygidakis²,

Ioannidis

et al. 2010

Eur J Pediatr

View full text Add to dashboard Cite

Bovine tuberculosis is a zoonotic disease, and although its incidence has dramatically decreased in developed countries where effective control measures are applied, it still remains a potential health hazard in the developing world. Tuberculosis of the oral cavity is extremely rare and is usually secondary to pulmonary involvement. We present the unusual case of an immunocompetent 6-year-old child residing in an urban area with primary oral tuberculosis due to Mycobacterium bovis, which was confirmed by the application of a molecular genetic approach. M. bovis belongs to Mycobacterium tuberculosis complex which comprises species with close genetic relationship, and for this reason, the use of new molecular techniques is a useful tool for the differentiation at species level of the closely related members of this complex.

show abstract

Proposed management of childhood tuberculosis in low-incidence countries

Cited by 14 publications

References 69 publications

Life-threatening disseminated tuberculosis as a complication of TNF-α blockade in an adolescent

Life-threatening disseminated tuberculosis as a complication of TNF-α blockade in an adolescent

Description of Pediatric Tuberculosis Evaluated in a Referral Center in Istanbul Turkey

Primary tooth abscess caused by Mycobacterium bovis in an immunocompetent child

Contact Info

Product

Resources

About