2000-2020 Yılları Arasında Biyopsi Tanısı Olan Tüberküloz Vakalarının İncelenmesi
Özet
Forty-six childhood extrapulmonary tuberculosis patients, 47.8% female and 52.2% male, who had biopsy between 2000 and 2020 were analyzed. The ages of the patients ranged from 5 months to 18 years. The rate of contact with a patient with tuberculosis (TB) was 20%. There was a concomitant disease in 15% of our patients, and immune suppression in 10%. BCG vaccination rate was 89.7%. The most common symptom was fever in 43.5%, followed by weight loss in 26.1% and neck swelling in 23.9%. Lymphadenopathy was the most common physical examination finding (27.9%). Tuberculin skin test (TST) was positive in 71.4% of the patients. TST positivity was 69.7% among patients who received BCG vaccine. TST was found to be positive in half of the patients whose interferon gamma release test was negative. No pathological finding was found in 80.4% of the chest radiographs taken at admission. The largest portion of the biopsies consisted of lymph nodes (43%). All biopsies had granulomatous inflammation, 74% of them were accompanied by necrosis. 31.1% of Ziehl-Neelsen stained biopsies were ARB positive. There was growth in culture in 64% of positive samples and 40% of negative samples. Among the patients whose polymerase chain reaction (PCR) were studied 50% were positive. The rate of PCR positivity was 72.7% in the group with positive culture growth. The most frequently involved organ was lymph nodes with 41.9%. In our study, the most common diagnosis of extrapulmonary tuberculosis was tuberculous lymphadenitis with a rate of 30.4%. Miliary TB was the second with 17.4%, and TB osteomyelitis was the third with 15.2%. The mean time between the onset of symptoms and diagnosis was 3.5 months. The mean duration of treatment was 9.8 months. The proportion of patients who were resistant to at least one drug was 23.5%. The successful treatment rate was found to be 80.4%.
