Author/Authors :
Baghaie, Nooshin Pediatric Respiratory Diseases Research Center - National Research Center of Tuberculosis and Lung Diseas - Masih Daneshvari Hospital - Shaheed Beheshti University of Medical Sciences, Tehran , Khalilzade, Soheila Pediatric Respiratory Diseases Research Center - National Research Center of Tuberculosis and Lung Diseas - Masih Daneshvari Hospital - Shaheed Beheshti University of Medical Sciences, Tehran , Boloursaz, Mohammad Reza Pediatric Respiratory Diseases Research Center - National Research Center of Tuberculosis and Lung Diseas - Masih Daneshvari Hospital - Shaheed Beheshti University of Medical Sciences, Tehran , Khodayari, Amir Ali Pediatric Respiratory Diseases Research Center - National Research Center of Tuberculosis and Lung Diseas - Masih Daneshvari Hospital - Shaheed Beheshti University of Medical Sciences, Tehran , Velayati, Ali Akbar Pediatric Respiratory Diseases Research Center - National Research Center of Tuberculosis and Lung Diseas - Masih Daneshvari Hospital - Shaheed Beheshti University of Medical Sciences, Tehran
Abstract :
Tuberculosis (TB) is an important health problem in developing countries, with varying clinical
presentations depending on the organs/systems involved. To study the spectrum of clinical and paraclinical
aspects of extra pulmonary TB in children suffering from pulmonary TB. This study has been carried out on
65 children with tuberculosis, admitted in TB wards of National Research Institute of Tuberculosis and Lung
Disease (N.R.I.T.L.D) during 2004-2006. All patients were investigated according to specific diagnostic
criteria including; history of contact with TB patient, clinical manifestations, radiological findings, tuberculin
test and bacteriologic or pathologic results and after confirmation, treatment was administered. Out of 65
cases, 14 had different types of extra pulmonary tuberculosis, and data concerning following factors were
studied: age, gender, race, site of involvement, bacteriology, pathology, ADA (ascitic fluid), PCR (tissue
specimens), history of close contact, HIV tests (ELISA), tuberculin test, radiological findings, and
immunological studies (in disseminated TB). Of 14 cases, 8 were girls and 6 were boys with mean age of
8.75±4.2. Nine patients were Iranian and 5 were Afghan. History of close contact was detected in 4 cases.
Type of involvement was: 5 cervical adenitis, 3 osteoaticular disease, 2 peritonitis and 2 disseminated form of
tuberculosis, one pericarditis, one renal tuberculosis. Radiological findings showed 4 pulmonary disease and
3 osteoarticular involvement. Tuberculin skin tests greater than 15 mm observed in 5 cases, 9 patients had 0-5
mm induration. 4 cases had concomitant pulmonary and extra pulmonary involvement. Positive AFB in
gastric lavage was recognized in 4 cases, in which 3 showed positive cultures for MTB. Pathological
examinations in 10 cases revealed granuloma with caseation compatible with tuberculosis, five in
lymphadenopaty, three in osteoarticular, two in abdominal tuberculosis. According to this study, 20% of
patients had extra pulmonary involvement, which is comparable to other reports (20-25%) and TB
lymphadenitis is the most common from of presentation.
