Cervical Tuberculous Lymphadenitis in a BCG Vaccinated Child

Objective: Our aim was to analyze the epidemiology and evaluate clinical features (symptoms) to search efficient tools helping to diagnose extra-pulmonary and pulmonary childhood tuberculosis.

Methods: We retrospectively reviewed medical records of patients aged less than 17 years, treated for active tuberculosis (TB) from January 2000 to January 2008 at Hospital Universitario Dr. José Eleuterio González.

Result:  Total of 45 patients with active TB were identified. Thirty- three children (73%) had extra-pulmonary TB (EPTB); the remaining had pulmonary TB (PTB).Mycobacterium tuberculosis was isolated mainly in the central nervous system and the meninges (27%). According to clinical observation, fever, cough and weight loss were present in most patients with pulmonary TB. Fever was the only symptom related within extra-pulmonary cases. Different analyses were performed to confirm diagnosis, such as direct microscopic screening of stained slides for acid-fast bacilli (AFB), culture, PCR, TST and chest radiography.

Conclusion: The majority of patients had extra-pulmonary TB. Fever was associated with both EPTB and PTB. Only cough and weight loss showed a significant difference between EPTB and PTB.