2005-2015 Yılları Arasında Hacettepe Üniversitesi Çocuk Göğüs Hastalıkları Bilim Dalında İzlenmekte Olan Tüberküloz Vakalarının İncelenmesi
Mete Yeşil, Ayşe
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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.