Tuberculosis in Children in a Pediatric Hospital in Mexico

• Published in: The American journal of tropical medicine and hygiene Vol. 106; no. 1; pp. 75 - 79
• Main Authors: Saldaña, Napoleón González, Parra, Mercedes Macías, Olguín, Hugo Juárez, Bejarano, José Iván Castillo, Soto, Monica Punzo, Jiménez, Francisca Trujillo
• Format: Journal Article
• Language: English
• Published: United States Institute of Tropical Medicine 01.01.2022; The American Society of Tropical Medicine and Hygiene
• Subjects: Adolescent; Child; Child, Preschool; Cohort Studies; Coloring Agents; Female; Hospitals, Pediatric; Humans; Male; Mexico - epidemiology; Mycobacterium tuberculosis - isolation & purification; Pathology, Molecular; Pediatrics; Retrospective Studies; Sensitivity and Specificity; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Tuberculosis - pathology; Tuberculosis, Lymph Node - diagnosis; Tuberculosis, Lymph Node - epidemiology; Tuberculosis, Lymph Node - pathology; Tuberculosis, Meningeal - diagnosis; Tuberculosis, Meningeal - epidemiology; Tuberculosis, Meningeal - pathology; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - pathology; Mexico
• ISSN: 0002-9637; 1476-1645; 1476-1645
• DOI: 10.4269/ajtmh.20-1482

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl–Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF ® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.