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      Tuberculosis infantil. ¿Cómo diagnosticarla? Translated title: Childhood tuberculosis. How to diagnose it?

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          Abstract

          La tuberculosis es uno de los padecimientos con mayor incidencia mundial. La infección se presenta cuando el Mycobacterium tuberculosis ingresa al organismo, y la enfermedad surge cuando se altera el estado inmunológico, nutricional y de vacunación. El diagnóstico en los niños se basa en el antecedente de contacto, la prueba de la tuberculina, la radiografía de tórax y el hallazgo microbiológico del bacilo; estos criterios ayudan a realizar un diagnóstico y tratamiento más tempranos, lo cual permite romper el ciclo biológico del M. Tuberculosis y evitar el incremento en la morbimortalidad de una comunidad.

          Translated abstract

          Tuberculosis is one of the conditions with higher incidence worldwide. Infection occurs when Mycobacterium enters the body, and its progression to disease occurs when immune, nutritional and vaccination status are altered. The diagnosis in children is based on elements such as contact history, tuberculin test, chest radiograph and microbiological finding of the bacillus, so these criteria will help us to make an early diagnosis and treatment, breaking the life cycle of M. tuberculosis, preventing an increase in morbidity and mortality in a community.

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          Most cited references64

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          Induced sputum or gastric lavage for community-based diagnosis of childhood pulmonary tuberculosis?

          To compare the diagnostic yield of Mycobacterium tuberculosis from induced sputum (IS) and gastric lavage (GL) among children in a community setting. Specimen-collection methods for bacteriological confirmation of pulmonary tuberculosis (PTB) were compared during a tuberculosis vaccine trial near Cape Town, South Africa (2001-2006). Children with a tuberculosis contact or compatible symptoms were investigated for suspected PTB. Diagnostic yields from 764 paired IS and GL specimens were compared in 191 culture-confirmed cases. The crude yield of M tuberculosis was 10.4%, n = 108 by IS (5.8%) and n = 127 by GL (6.8%), from a total of 194 cases, of which three had incomplete IS/GL specimen pairs. Agreement between IS and GL was poor (kappa = 0.31). The comparative yield of a single IS sample (38%) was equivalent to a single GL sample (42%), with a difference in yield of -4% (95% CI -15% to +7%). The combined yield of same-day IS and GL specimens (67%) was equivalent to two consecutive GL specimens (66%), with a difference in yield of 1% (95% CI -9% to 11%), but significantly greater than two consecutive IS specimens (55%), with a difference in yield of 12% (95% CI 2% to 21%). The adjusted odds of a M tuberculosis culture were increased by a positive tuberculin skin test or chest radiograph compatible with PTB. In this community setting, the diagnostic yield of a single IS sample was equivalent to that of a single GL sample. The optimal diagnostic yield may be obtained from paired IS and GL specimens taken on a single day or two GL specimens taken on consecutive days.
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            Tuberculosis in children.

            J Starke (2004)
            The natural history and clinical expression of infection due to Mycobacterium tuberculosis differ substantially in children compared with adults. The natural history depends upon the age at infection and the host immune status. Children infected prior to age 4 have a very high rate of developing immediate clinical or radiographic manifestations or both, but are unlikely to develop reactivation disease in adulthood. In contrast, children infected in preadolescence or adolescence are more prone to developing more severe adult-type pulmonary tuberculosis soon after infection or in adulthood. It is difficult to confirm the diagnosis of tuberculosis by current microbiological methods. Even in industrialized countries, the triad of a positive tuberculin skin test, radiographic and/or clinical manifestations consistent with tuberculosis, and establishing a recent link to a known infectious case of tuberculosis is the "gold standard" for diagnosis. Children with tuberculosis respond well to and tolerate the same basic treatment regimens as used for adults. Some prevention of childhood tuberculosis can be achieved by the use of the bacille Calmette-Guérin (BCG) vaccines, but the use of chemotherapy to treat recent tuberculosis infection, discovered via contact tracing, is of paramount importance even when BCG vaccines are used.
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              Manual para el diagnóstico bacteriológico de la tuberculosis. Normas y guía técnica: Parte 1 Baciloscopia

              (2008)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                aap
                Archivos argentinos de pediatría
                Arch. argent. pediatr.
                Sociedad Argentina de Pediatría (Buenos Aires )
                1668-3501
                April 2012
                : 110
                : 2
                : 144-151
                Affiliations
                [1 ] Instituto Nacional de Enfermedades Respiratorias Dr. Ismael Cosío Villegas Mexico
                Article
                S0325-00752012000200011
                10.5546/aap.2012.144
                22451288
                e16721c4-905d-4f6b-8f80-32709f562ded

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Argentina

                Self URI (journal page): http://www.scielo.org.ar/scielo.php?script=sci_serial&pid=0325-0075&lng=en
                Categories
                PEDIATRICS

                Pediatrics
                Diagnóstico,Mycobacterium tuberculosis,Niños,Tuberculosis infantil,Smear,Diagnosis,Children,Childhood tuberculosis,Baciloscopia

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