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Clinical Review of Tuberculosis in Childhood.

Journal of the Korean Pediatric Society 1985;28(12):1196-1206.
Published online December 31, 1985.
Clinical Review of Tuberculosis in Childhood.
Hyung Ja Park, Soon Wha Kim, Don Hee Ahn, Keun Chan Sohn
Department of Pediatrics, National Medical Center
小兒結核入院患者에 對한 臨床的 考察(診斷을 위한 採點方式의 檢討)
朴磨子, 金順華, 安敎迫, 孫權贊
國立醫療院 小兒科
Abstract
A clinical review was made on 202 cases of tuberculosis who had been admitted at Pediatric department, National Medical Center during the period of 5 years and 6 months from January, 1979 to June 1984. The following results were obtained: 1)Annual incidence seemed to be slightly increased during this period. 2)The highest age incidence was in the group of 1 to 3 years and male patients were dominant over female patients in the ratio of 1.6 : 1. 3)Seasonal distribution showed slightly increased in spring and decreased in autumn. 4)Socioeconomic background showed that the most patients belonged to low or middle class. 5)Contact history with tuberculosi patient in the family could be found in 35.6% of the patients. Parents were the most common source and grand-parents, relatives and siblings were in order of frequency. 6)Pulmonary lesion was found in 103 cases, that was 50.9% of 202 patients and meningitis 28.7%, pleurisy 21.2%, miliary uberculosis 11.2%, followed by lymph node, intestine, bone and joint, kidney lesions in order of frequency. 7)B.C.G. vaccination was done in 44.5% of the patients. In B.C.G. non-vaccinated group, tuberculous meningitis occured more frequently compared to vaccinated group. (p<0.005) 8)Fever was the most common chief complaint on admission (68.3%) and then followed by cough, headache, vomiting, dyspnea, general weakness in that orders. 9)Tuberculin test showed 91.6% positive rate. 10) On laboratory data, anemia was found in 22.1%, leukocytosis was found in 46.5% and erythrocyte sedimentation rate was elevated in 47.9%. 11)Microbiologic study revealed 18.8% positive data to Mycobacterium tuberculosis. Smear positive rate was 4.2% and culture positive rate was 15.8%. 12)Chest X-ray showed abnormal findings in 82.7% of the patients. Both lungs were involved in most cases and right side was more commonly affected than the left side. 13)143 cases were treated with triple drugs (INH, SM with RIF or PAS or EMB) and prednisolone was added in 39 cases. 14)Duration of hospitalization was one to two weeks in most cases. Mean duration was 18 days and the longest duration was 152 days. 15)Mean cure rate was 62.6% and mean mortality rate was 7.8%. Among the cured patients, 6 cases were complicated by sequelaes.
Key Words: Tuberculosis, Scoring system


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