Abstract
Tuberculosis (TB) in children is a common cause of morbidity. Diagnosis is difficult because of paucibacillary nature of illness and difficulty in obtaining appropriate samples. Children presenting with poor weight gain, fever with or without cough for more than two weeks or contact with an adult in family with pulmonary tuberculosis should be investigated for TB. In all suspected cases of tuberculosis initial investigations include radiograph of chest (CXR) and Mantoux test. If CXR is suggestive of TB, an ambulatory gastric aspirate and induced sputum for acid fast bacilli (AFB) smear may be carried out in two days. Children with AFB positive or abnormal CXR with positive Mantoux test should be started on Antitubercular therapy (ATT). Rest of the patients require more investigations and should be referred to a specialist. All children with newly diagnosed tuberculosis should be treated with 6 mo of ATT (two months with 4 drugs, followed by four months with 2 drugs). Children on ATT should be monitored for improvement in symptoms and weight gain along with side effects of medications. CXR should be done after completion of treatment.
Similar content being viewed by others
References
World Health Organization. Global Tuberculosis Report 2013. http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf
Working Group on Tuberculosis, Indian Academy of Pediatrics (IAP). Consensus statement on childhood tuberculosis. Indian Pediatr. 2010;47:41–55.
Mukherjee A, Singh S, Lodha R, Singh V, Hesseling AC, Grewal HM, et al; Delhi Pediatric TB Study Group. Ambulatory gastric lavages provide better yields of mycobacterium tuberculosis than induced sputum in children with intrathoracic tuberculosis. Pediatr Infect Dis J. 2013;32:1313–7.
Lodha R, Mukherjee A, Saini D, Saini S, Singh V, Singh S, et al. Delhi TB study group. Role of the QuantiFERON®-TB gold in-tube test in the diagnosis of intrathoracic childhood tuberculosis. Int J Tuberc Lung Dis. 2013;17:1383–8.
Lodha R, Kabra SK. Newer diagnostic modalities for tuberculosis. Indian J Pediatr. 2004;71:221–7.
Contributions
PK, AK, RL and SKK: Involved in literature search and manuscript writing. SKK will act as guarantor for this paper.
Conflict of Interest
None.
Source of Funding
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kumar, P., Kumar, A., Lodha, R. et al. Childhood Tuberculosis in General Practice. Indian J Pediatr 82, 368–374 (2015). https://doi.org/10.1007/s12098-014-1577-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-014-1577-2