Clinical and sociodemographic characteristics of children, younger than 13 years, with or without a confirmed diagnosis of pulmonary tuberculosis, at Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 2007-200

Abstract

Introduction: Worldwide, tuberculosis is one of the most important infectious and contagious diseases. It is associated with high morbidity and mortality rates. In children, tuberculosis is most frequently pulmonary but it may affect every organ and system. Its consequences, if inadequately treated, may be severe. Symptoms and signs are diverse and nonspecific, and the bacteriological confirmation is difficult in children. For these reasons, making the diagnosis in the pediatric population may be a really difficult challenge.

Objective: To determine the sociodemographic and clinical characteristics of a group of children with suspicion or confirmed diagnosis of pulmonary tuberculosis.

Methodology: Fifty six children were studied at Hospital Universitario San Vicente de Paúl, in Medellín, Colombia, between July 2007 and December 2008. Pulmonary tuberculosis was confirmed according to the WHO criteria. Information was obtained from the patients themselves, their parents, and the hospital files.

Results: In 38 of the 56 children (67.9%) pulmonary tuberculosis was confirmed. Their socioeconomic situation was poor in 87.5% of the cases; 55% came from the urban area of the city; 70% were mestizo, and 26.8%, Indians. Cough and fever were the predominant clinical manifestations. The positivity rate of diagnostic criteria was as follows: 53.6% for the epidemiological, 51.6% for the radiological, and 41.1% for the tuberculin test.

Conclusion: Pulmonary tuberculosis continues to be of great importance in the pediatric population. A high degree of clinical suspicion is necessary in order to make the diagnosis because clinical manifestations are variable and nonspecific. A previous contact with an adult positive for acid-fast bacilli is an alarm sign and should lead to diagnostic tests. PPD and radiology are very helpful for diagnostic purposes. Isolation of M. tuberculosis is unlikely from children.