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A retrospective analysis of paediatric tuberculosis diagnosis in London: room for improvement?
  1. Tejshri Shah1,
  2. Bhanu Williams2,
  3. Daniel Langer3,
  4. Hannah Mitchell4,
  5. Andrea Togo5,
  6. Alexandra Y Kreins6,
  7. Laura Caddle1,
  8. Sreena Das2,
  9. Miranda Lutkin7,
  10. James A Seddon8
  1. 1 Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK
  2. 2 Department of Paediatrics, London North West Healthcare, London, UK
  3. 3 Department of Paediatric Infectious Diseases, St. Mary's Hospital, London, UK
  4. 4 Department of Paediatrics, The Whittington Hospital, London, UK
  5. 5 Department of Paediatrics, St. George's Hopsital, London, UK
  6. 6 Department of Paediatric Infectious Diseases, Evelina London Children's Hospital, London, UK
  7. 7 Department of Paediatrics, Ealing Hospital, Southall, Middlesex, UK
  8. 8 Department of Paediatrics, Imperial College, London, UK
  1. Correspondence to Dr Tejshri Shah; tejshri.shah{at}nhs.net

https://doi.org/10.1136/archdischild-2015-309128

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    Tuberculosis (TB) in children can be challenging to diagnose with microbiological certainty. Younger children are unable to expectorate sputum and the bacillary load is frequently low; few children with a clinical diagnosis of pulmonary TB have this confirmed microbiologically. Similarly, confirmation of extra-pulmonary TB, using other samples, can be difficult.1

    Despite these challenges, 27 TB guidelines, including those produced by the National Institute for Health and Care Excellence, recommend that microbiological confirmation is attempted in all children with suspected TB, and that where pulmonary TB is suspected, three samples should be sent.2 Microbiological diagnosis is useful for a number of reasons: it confirms the diagnosis, it allows epidemiological data regarding strain …

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    Footnotes

    • Contributors TS and JAS conceived the study, developed the data collection tool, undertook data analysis and wrote the paper. BW, DL, HM, AT, AYK, LC, SD and ML contributed to data collection and critically reviewing the paper.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.