Gülsüm İclal BAYHAN, Ayşe Seçil EKŞİOĞLU, Burçak ÇELİK KİTİŞ, Gönül TANIR

Pulmonary tuberculosis in infants less than one year old: implications for early diagnosis

Tüberküloz büyük çocuklarda iyi tanımlanmakla birlikte infantil tüberküloz çok iyi bilinmemektedir. Literatürde infantil tüberküloz ile ilgili çok az makale bulunmaktadır. Bu çalışmada Şubat 2007-Mayıs 2009 tarihleri arasındaki infantil tüberküloz olguları retrospektif olarak incelendi. Pulmoner tüberkülozlu 13 olgu saptandı. Hastaların en sık semptomları öksürük (%72.4), gece terlemesi (%35.7) ve ateşti (%21.4). Dört hastada hiçbir semptom yoktu. On üç hastanın 12’sinin fizik muayenesi normaldi. Tüm hastaların -akciğer grafisi normal olanların da- toraks bilgisayarlı tomografilerinde patoloji saptandı. Hastaların tümü antitüberküloz tedaviyi iyi tolere etti ve tedavi ile düzeldi. İnfantil tüberkülozun önlenmesi esas olarak aile içi tüberkülozlu olguların erken tespiti ve tedavisine dayanır. Bu çalışma yüksek şüphe, akciğer grafisi ve bilgisayarlı tomografinin doğru kullanımıyla infantil tüberkülozun erken tanısının mümkün olduğunu göstermiştir. Erken tanı ve tedavi hastalığın disseminasyonunu azaltabilir ve mortaliteyi düşürebilir; bu nedenle pediatristler infantil tüberküloz konusunda uyanık olmalıdır.

Bir yaş altı bebeklerde akciğer tüberkülozu: Erken tanının önemi

Tuberculosis in older children has been well described; however, its description in infants is very limited. There are a few studies of infants with tuberculosis in the literature. In this study from February 2007 to May 2009, cases of infantile tuberculosis investigated retrospectively. Thirteen patients with pulmonary tuberculosis detected. Mean age of the patients was 168.8 days. The most frequent symptoms were cough in 10 (72.4%) patients, night sweating in five (35.7%) and fever in three (21.4%). Four patients didn’t have any symptoms. Physical examinations were normal in 12 patients. Thorax computerized tomography studies of all of the patients were abnormal included the cases with normal chest radiographies. Antituberculosis treatment was well tolerated by all of the patients and all of them improved. Prevention of tuberculosis in infants rest upon the early detection and treatment of tuberculosis of the infant’s household members. This study demonstrates that with high index of suspicion and the correct use of chest radiographs and thorax computerized tomography, the disease diagnosed early in infants. Early diagnosis and treatment may prevent dissemination and may reduce mortality, so pediatrician should alert for tuberculosis in infants.

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