Abstract
Children with low-flow congenital heart lesions are reported to have an increased incidence of pulmonary tuberculosis. The aim of this study was to investigate if children with congenital heart disease have an increased incidence of pulmonary tuberculosis and to determine if patients with certain heart conditions are more susceptible to pulmonary tuberculosis than others. This retrospective study over a 6-year period showed that pulmonary tuberculosis was 2.5-fold more common in children with congenital heart disease than in normal children from the same community. Children with congenital pulmonary stenosis had a prevalence equal to those with acyanotic (ventricular and atrial septal defects) and cyanotic (transposition of the great arteries) high-flow heart lesions, whereas there were no cases of tuberculosis in children with low-flow cyanotic heart lesions such as tetralogy of Fallot. Cardiac surgery had to be postponed as a result of pulmonary tuberculosis in 7.2% of all patients in whom it was required. Over the 6-year period of the study, cardiac surgery had to be delayed in 60% of cases with pulmonary tuberculosis and congenital heart lesions so antituberculosis therapy could be completed. Physicians treating children with congenital heart lesions should maintain a high index of suspicion for the development of pulmonary tuberculosis, especially in those with acyanotic and cyanotic high-flow lesions and pulmonary stenosis.
Similar content being viewed by others
References
Behrman RE, Vaughan VC, Nelson WE (1987) The cardiovascular system. In: Nelson Textbook of Pediatrics, 13th ed. Saunders, Philadelphia, p 392
Berman S, Kibel MA, Fourie PB, Strebel PM (1992) Childhood tuberculosis and tuberculous meningitis: high incidence rates in the western cape of South Africa.Tuberc Lung Dis 73:39–44
Beyers N, Gie RP, Schaaf HS, et al. (1994) Delay in the diagnosis, notification and initiation of treatment and compliance in children with tuberculosis.Tuberc Lung Dis (in press)
Cundall DB (1986) The diagnosis of pulmonary tuberculosis in malnourished Kenyan children.Ann Trop Paediatr 6:249–255
De Medeiros JC, Sobrinho JH, Kambara AM, da Silva MV, Fontes VF (1986) Estenose pulmonar congenita e tubercoulose: a presentacao de 3 cascs. [Congenital pulmonary stenosis and tuberculosis: report of 3 cases.]Arq Bras Cardiol 46:329–335
Gie RP, Beyers N, Schaaf HS, Donald PR (1993) Missed opportunities in the diagnosis of pulmonary tuberculosis in children.S Afr Med J 83:263
Grzybowski S (1991) Tuberculosis in the Third World.Thorax 46:689–691
Jacobs M, Yach D, Fisher S, et al. (1987) Management of children with tuberculosis in a local authority of Cape Town.S Afr J Epidem Infect 2:15–18
Kustner HGV (1991) Tuberculosis in the Cape Province.Epidemiol Comments 18:3–24
Lewis T (1934) Diseases of the Heart. Macmillan, London
Rosner B (1990) Fundamentals of Biostatistics. PWS Kent Publishing, Boston
Sham MK, Humphries MJ, Gabriel M (1989) Childhood respiratory tuberculosis in Hong Kong: a study of 301 children with respiratory tuberculosis treated at Ruttonjee Sanatorium.Hong Kong J Paediatr 6:3–8
Steenkamp JHB (1991) Tuberculosis control programme—1990.Epidemiol Comments 18:175–184
Stoltz AP, Donald PR, Strebel PM, Talent JMT (1990) Criteria for the notification of childhood tuberculosis in a highincidence area of the western Cape Province.S Afr Med J 77:385–386
Swanevelder R (1992) Second national HIV survey of women attending antenatal clinics, South Africa, October/November 1991.Epidemiol Comments 19:80–89
World Health Organization (1983) Provisional Guidelines for the Diagnosis and Classification of the EPI Target Diseases for Primary Care, Surveillance and Special Studies. WHO, Geneva
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van der Merwe, P.L., Kalis, N., Schaaf, H.S. et al. Risk of pulmonary tuberculosis in children with congenital heart disease. Pediatr Cardiol 16, 172–175 (1995). https://doi.org/10.1007/BF00794188
Issue Date:
DOI: https://doi.org/10.1007/BF00794188