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Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience

AIM: Extrapulmonary tuberculosis is observed more frequently and leads to complications with a higher rate in children compared with adults because the risk of lymphohematogen spread is higher. In this study, the clinical, laboratory, and radiologic findings and treatment outcomes were evaluated in...

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Autores principales: Kaba, Özge, Kara, Manolya, Odacılar, Cemile Ayşe, Kamer, İbrahim, Sütçü, Murat, Demir, Sevliya Öcal, Çalışkan, Emine, Törün, Selda Hançerli, Salman, Nuran, Somer, Ayper
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666364/
https://www.ncbi.nlm.nih.gov/pubmed/31384143
http://dx.doi.org/10.14744/TurkPediatriArs.2019.33239
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author Kaba, Özge
Kara, Manolya
Odacılar, Cemile Ayşe
Kamer, İbrahim
Sütçü, Murat
Demir, Sevliya Öcal
Çalışkan, Emine
Törün, Selda Hançerli
Salman, Nuran
Somer, Ayper
author_facet Kaba, Özge
Kara, Manolya
Odacılar, Cemile Ayşe
Kamer, İbrahim
Sütçü, Murat
Demir, Sevliya Öcal
Çalışkan, Emine
Törün, Selda Hançerli
Salman, Nuran
Somer, Ayper
author_sort Kaba, Özge
collection PubMed
description AIM: Extrapulmonary tuberculosis is observed more frequently and leads to complications with a higher rate in children compared with adults because the risk of lymphohematogen spread is higher. In this study, the clinical, laboratory, and radiologic findings and treatment outcomes were evaluated in pediatric patients who were followed up in our clinic with a diagnosis of extrapulmonary tuberculosis. MATERIAL AND METHODS: Seventy patients aged 0–18 years who were followed up with a diagnosis of extrapulmonary tuberculosis between 2008 and 2017 in the Division of Pediatric Infectious Diseases in our hospital were examined retrospectively. RESULTS: The median age of the patients was 8,8 (range, 0,4–17) years and 47.1% were female (n=33). Twenty-seven patients (38.6%) were aged 0–4 years, 15 (21.4%) were aged 5–9 years, and 28 patients (40%) were aged 10–18 years. Forty-four patients (62.9%) were diagnosed as having extrapulmonary tuberculosis and 26 (37.1%) had pulmonary + extrapulmonary tuberculosis. The most common form of extrapulmonary tuberculosis was extrathoracic lymphadenopathy, which was found in 22 patients (31.4%). The other patients were diagnosed as having musculoskeletal system tuberculosis (n=10, 14.3%), gastrointestinal system tuberculosis (n=9, 12.9%), miliary tuberculosis (n=8, 11.4%), intrathoracic lymphadenopathy (n=7, 10%), renal tuberculosis (n=6, 8.6%), central nervous system tuberculosis (n=5, 7.1%), and pleural tuberculosis (n=3, 4.3%). Among a total of 58 patients in whom tuberculin skin test and interferon gamma release tests were studied together, tuberculin skin test positivity (n=37, 63.8%) was found with a higher rate compared with interferon gamma release test positivity (n=32, 55.2%), but the difference was not statistically significant (p=0.35). The median treatment period was 12 (range, 6–24) months. Among the patients whose treatments were terminated, improvement was observed in 52 patients (74.2%) and the development of sequela was observed in six patients (8.5%). Two patients who were diagnosed as having central nervous system tuberculosis (2.8%) died. CONCLUSION: Clinical, laboratory, and radiologic data should be evaluated together when making a diagnosis of extrapulmonary tuberculosis in children. Interferon gamma release tests alone are not superior to tuberculin skin test, but should be considered to be used in combination in the diagnosis.
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spelling pubmed-66663642019-08-05 Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience Kaba, Özge Kara, Manolya Odacılar, Cemile Ayşe Kamer, İbrahim Sütçü, Murat Demir, Sevliya Öcal Çalışkan, Emine Törün, Selda Hançerli Salman, Nuran Somer, Ayper Turk Pediatri Ars Original Article AIM: Extrapulmonary tuberculosis is observed more frequently and leads to complications with a higher rate in children compared with adults because the risk of lymphohematogen spread is higher. In this study, the clinical, laboratory, and radiologic findings and treatment outcomes were evaluated in pediatric patients who were followed up in our clinic with a diagnosis of extrapulmonary tuberculosis. MATERIAL AND METHODS: Seventy patients aged 0–18 years who were followed up with a diagnosis of extrapulmonary tuberculosis between 2008 and 2017 in the Division of Pediatric Infectious Diseases in our hospital were examined retrospectively. RESULTS: The median age of the patients was 8,8 (range, 0,4–17) years and 47.1% were female (n=33). Twenty-seven patients (38.6%) were aged 0–4 years, 15 (21.4%) were aged 5–9 years, and 28 patients (40%) were aged 10–18 years. Forty-four patients (62.9%) were diagnosed as having extrapulmonary tuberculosis and 26 (37.1%) had pulmonary + extrapulmonary tuberculosis. The most common form of extrapulmonary tuberculosis was extrathoracic lymphadenopathy, which was found in 22 patients (31.4%). The other patients were diagnosed as having musculoskeletal system tuberculosis (n=10, 14.3%), gastrointestinal system tuberculosis (n=9, 12.9%), miliary tuberculosis (n=8, 11.4%), intrathoracic lymphadenopathy (n=7, 10%), renal tuberculosis (n=6, 8.6%), central nervous system tuberculosis (n=5, 7.1%), and pleural tuberculosis (n=3, 4.3%). Among a total of 58 patients in whom tuberculin skin test and interferon gamma release tests were studied together, tuberculin skin test positivity (n=37, 63.8%) was found with a higher rate compared with interferon gamma release test positivity (n=32, 55.2%), but the difference was not statistically significant (p=0.35). The median treatment period was 12 (range, 6–24) months. Among the patients whose treatments were terminated, improvement was observed in 52 patients (74.2%) and the development of sequela was observed in six patients (8.5%). Two patients who were diagnosed as having central nervous system tuberculosis (2.8%) died. CONCLUSION: Clinical, laboratory, and radiologic data should be evaluated together when making a diagnosis of extrapulmonary tuberculosis in children. Interferon gamma release tests alone are not superior to tuberculin skin test, but should be considered to be used in combination in the diagnosis. Kare Publishing 2019-07-11 /pmc/articles/PMC6666364/ /pubmed/31384143 http://dx.doi.org/10.14744/TurkPediatriArs.2019.33239 Text en Copyright: © 2019 Turkish Archives of Pediatrics http://creativecommons.org/licenses/by-nc-sa/4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
Kaba, Özge
Kara, Manolya
Odacılar, Cemile Ayşe
Kamer, İbrahim
Sütçü, Murat
Demir, Sevliya Öcal
Çalışkan, Emine
Törün, Selda Hançerli
Salman, Nuran
Somer, Ayper
Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title_full Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title_fullStr Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title_full_unstemmed Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title_short Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
title_sort evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666364/
https://www.ncbi.nlm.nih.gov/pubmed/31384143
http://dx.doi.org/10.14744/TurkPediatriArs.2019.33239
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