2005-2015 Yılları Arasında Hacettepe Üniversitesi Çocuk Göğüs Hastalıkları Bilim Dalında İzlenmekte Olan Tüberküloz Vakalarının İncelenmesi

Abstract

Between 2005 and 2015, 93 cases with tuberculosis (TB) diagnosed or receiving treatment in Hacettepe University Pediatric Pulmonology Department were reviewed retrospectively. 51.6% of the patients had pulmonary tuberculosis; extrapulmonary involvement in 33.3%; pulmonary tuberculosis with extrapulmonary involvement in 15.1%. The history of contact with an adult with tuberculosis was found in 29% of cases. The most common extrapulmonary TB was TB lymphadenitis observed in 16.1% of the patients. 91.9% of the patients had BCG vaccination. The highest rate of non-vaccination was observed in patients with tuberculous meningitis (33.3%) followed by tuberculous lymphadenitis (18.2%) and miliary tuberculosis (16.7%). Primary immunodeficiency was present in 9,3% of patients. The most common complaint was cough (42.5%) followed by fever (41.9%) and night sweat (22.6%). 21.5% of the patients had normal physical examination at the time of diagnosis. The most common findings in chest X-ray were infiltration (25.8%) and lymphadenopathy (19.3%), and lymphadenopathy (43.5%) was the most common finding in thorax CT. Tuberculin skin test (TST) was positive in 72.2% of the patients, and TST measurement of inudration was significantly lower in the disseminated TB group (p < 0,001). 20.4% of the patients had culture, 17.2% had PCR (polymerase chain reaction) and 15% had ARB (acid resistant bacillus) positivity. In 21.4% of patients with culture reproduction, at least one anti-TB drug resistance was found. Two patients were diagnosed as congenital TB; it was observed that mothers were diagnosed only after diagnosis of children. The mean duration of treatment of patients treated according to the nayional guideline was 8.6 months (range 6 to 36 months). 11.8% of the patients received additional steroid treatment; Paradoxical response was observed in 2 patients (2.1%) as worsening of neurological findings. The clinical improvement was achieved in 75.7% of the patients with pulmonary TB in the first 2 months. Radiological improvement was observed in 56.8% of patients with pulmonary TB between 2-6 months. Recovery was seen in 91.4% of patients and mortality rate was 1.1%. Reactivation was detected in 3.2% of patients and 4,3% of patients were transferred. Although there is a decrease in the frequency of tuberculosis, it is a very important public health problem in the world and in our country. The most important way to fight against childhood TB is to prevent adult tuberculosis.