Clinical Characteristics of Tuberculosis in School-Age Children and Adolescents at a Single Institution

Seung Ho Yang; Mi Ae Chu; Hye Jin Park; Kye Hyang Lee; Jin Kyung Kim; Eun Jin Choi; Kyung Hoon Lee; Woo Taek Kim; Hai Lee Chung

doi:10.7581/pard.2012.22.3.239

Journal List > Pediatr Allergy Respir Dis > v.22(3) > 1033180

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Yang, Chu, Park, Lee, Kim, Choi, Lee, Kim, and Chung: Clinical Characteristics of Tuberculosis in School-Age Children and Adolescents at a Single Institution

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(3): 239-247.

Published online: 30 September 2012

DOI: https://doi.org/10.7581/pard.2012.22.3.239

Clinical Characteristics of Tuberculosis in School-Age Children and Adolescents at a Single Institution

Seung Ho Yang, MD, Mi Ae Chu, MD, Hye Jin Park, MD, Kye Hyang Lee, MD, Jin Kyung Kim, MD, Eun Jin Choi, MD, Kyung Hoon Lee, MD, Woo Taek Kim, MD, Hai Lee Chung, MD

Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea.

Corresponding author (hlchung@cu.ac.kr)

Received 27 March 2012 Revised 3 June 2012 Accepted 28 July 2012

Abstract

Purpose

In the present study, we investigated the clinical characteristics of tuberculosis in school-age children and adolescents, which is important as a reservoir for future disease burden.

Methods

Ninety patients, aged from 6 to 18 years, who were diagnosed and treated with tuberculosis during the period from January 2005 to July 2011, were enrolled. We retrospectively analyzed the medical records and investigated clinical characteristics of the patients.

Results

Eight patients were 6 to 12 (9%) and 82 were over 13 years of age (91%). There was a significantly higher percentage of males than females in the latter age group (P<0.01). Route of infection was not confirmed in 74 patients, and 16 patients were diagnosed through the school or military medical examinations with no clinical symptoms. Seventy patients (78%) were presented with pulmonary tuberculosis. Chronic persistent coughing was the most common presenting symptom, and both upper lobes were most frequently involved. Nineteen patients over 13 years of age had adult-type cavitary tuberculosis. The positive results for acid-fast smears or cultures were not high, and the rate of positive tuberculin skin test was 88%. The most frequent adverse effects of anti-tuberculosis treatment were hepatotoxicity, hyperuricemia, and gastrointestinal disorders. The duration of the treatment was much prolonged in 8 patients who had drug-resistant tuberculosis.

Conclusion

Our study showed that pulmonary tuberculosis should be suspected in the adolescents who have prolonged respiratory symptoms. It also indicates that pulmonary tuberculosis in adolescents has similar characteristics to tuberculosis in adults, which suggests the potential important role of adolescent tuberculosis in community disease transmission.

Keywords: Tuberculosis, School-age, Adolescents

Figures and Tables

Table 1

Clinical Characteristics of the Patients

Values are presented as mean±SD or number (%).

Table 2

Characteristics of Extra-pulmonary Tuberculosis

Table 3

Clinical Findings of the Patients at Diagnosis (n=90)

Values are presented as number (%) or mean±SD.

Table 4

Radiologic Findings of Pulmonary and Pleural Tuberculosis (n=90)

Table 5

Laboratory Findings of the Patients

TB, tuberculosis; AFB, acid fast staining; PCR, polymerase chain reaction.

Table 6

Adverse Effects of Anti-tuberculosis Drugs (n=27)

^*No. of patients with tuberculosis (n=90).

Table 7

Clinical Characteristics of the Drug-resistant Cases

H, isoniazid; R, rifampin; Z, pyrazinamide; E, ethambutol; CPM, capreomycin; Cs, cycloserine; Km, kanamycin; Ofx, ofloxacin; PAS, p-aminosalicylic acid; S, streptomycin; MDR, multi-drug resistant; Pto, prothionamide.

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