Abstract
Since 1977, 182 children have been enrolled for treatment of active tuberculosis. Diagnosis was made on the basis of a positive tuberculin skin test with compatible chest roentgenogram or physical examination abnormalities. A pediatrician, senior author, saw most of the patients and reviewed the records of the rest. Cultures were obtained from 42 patients, with 19 positive for M. tuberculosis. Presentation with symptoms resulted in diagnosis in 31 (17%), case contact investigation in 128 (70%) and routine screening in 23 (13%). Ages ranged from 2½ months to 15 years, median 3 years, with 50 under 2 years. Only 20 were hospitalized. Pulmonary disease was present in 170, 85% were asymptomatic. Hilar adenopathy alone was seen in 116, infiltrates in 56, miliary disease and pleural effusion in 4 each and 5 had cavities. Extrapulmonary disease was seen in 12, 11 with cervical adenitis and 1 with arthritis. Patients were monitored and medication dispensed by public health nurses, under the supervision of the authors. Treatment was with largely twice weekly INH and rifampin for 6 months for cases with hilar adenopathy alone, 9 months for all others. Respiratory symptoms cleared quickly; cervical nodes in 2-7 months. Most roentgenograms were free of infiltrates in less than a year but hilar adenopathy lasted 1-3 years. Two had drug toxicity (vomiting, rash). Therapy was successfully completed in 168, with greater than 2 year follow-up in 116 without relapse. A pediatrician helps assure good care for children in a Health Department Tuberculosis Program.
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Abernathy, R., Moers, D., Stead, W. et al. CHILDHOOD TUBERCULOSIS. Pediatr Res 21 (Suppl 4), 321 (1987). https://doi.org/10.1203/00006450-198704010-00922
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DOI: https://doi.org/10.1203/00006450-198704010-00922