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1715 Tuberculosis in Children - Still Diagnosis Challenge
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  1. M Dilberovska,
  2. N Uzunovska,
  3. D Dacevski
  1. Institute for Respiratory Diseases in Children-Kozle, Skopje, FYR Macedonia

Abstract

Aim Retrospective analyze of evaluation for tuberculosis (TB) diagnosis in children.

Materials and Method At the TB Department, for a period of 2007–2011 yr., data of treated patients were evaluated. Analyze was made on the base of diagnostic parameters: anamnesis data (positive TB control, beginning and symptoms of the disease); BCG vaccine and Mantoux test; and results of following investigations: hematology, microbiology, radiology, fiberbronchoscopy, toracocentesis, lumbal punction etc.

Results In the noted period, 267 children with TB were treated at the Department. Primary TB was presented in 229 (85, 8%) of them. Age group of 5–9 yr. was the most frequent in 147 (55.1%) children. Positive familiar TB contact was evident in 153 (57.3%) and positive Mantoux skin test in 179 (67.0%). Pleural effusion in 21 (7.9%) and cavernous changes (4.4%) were shown on the lung radiograms. In 57 (21.3%) children, lung TB was associated with non-specific disease (pneumonia in 23 (40.4%). From microbiological investigation: M.tuberculosis (culturally) was positive in 17 (6.6%); in relation with other bacteria, the most frequent was Haemophilus influenza in 19 (9.6%) children. Fiberbronchoscopy showed changes for TB endobronchitis in 29 (10.9%) children. Other diagnostic procedures were performed in connection with the form of TB.

Conclusion TB diagnostic in children is very difficult to be made. It requires long time period and numbered diagnostic investigations, especially in small children, because of the association with non-specific lung diseases that is very often.

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