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Tuberculosis in Children in a Pediatric Hospital in Mexico

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  • 1 Department of Infectology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico;
  • | 2 Department of Pharmacology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico;
  • | 3 Department of Pharmacology, Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico

ABSTRACT.

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl–Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.

Author Notes

Address correspondence to Hugo Juárez Olguín, Laboratorio de Farmacología, Instituto Nacional de Pediatría, Avenida Imán N 1, 3rd piso Colonia Cuicuilco, CP 04530, Ciudad de Mexico. E-mail: juarezol@yahoo.com

Ethical approval and consent to participate: Ethics approbation and consent to participate was authorized by The Academic College of the National Institute of Pediatrics.

Authors’ addresses: Napoleón González Saldaña, Mercedes Macías Parra, and José Iván Castillo Bejarano, Department of Infectology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico, E-mails: drnagosal@hotmail.com, mermacpar@hotmail.com, and jicastillobejarano@hotmail.com. Hugo Juárez Olguín, Department of Pharmacology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico, and Department of Pharmacology, Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico, E-mail: juarezol@yahoo.com. Monica Punzo Soto and Francisca Trujillo Jimenez, Department of Pharmacology, Instituto Nacional de Pediatria (INP), Mexico City, Mexico, E-mails: mon9120@gmail.com and fratruj@gmail.com.

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