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Clinical and Epidemiological Studies on 113 cases of Miliary Tuberculosis in Korean Children.

Journal of the Korean Pediatric Society 1984;27(8):786-794.
Published online August 31, 1984.
Clinical and Epidemiological Studies on 113 cases of Miliary Tuberculosis in Korean Children.
H S Kim, H I Lee, S H Kim, T C Kwon, C M Kang
Pediatric Department, Keimyung University School of Medicine, Taegu, Korea
소아의 속립성 결핵에 관한 임상 및 역학적 고찰
김흥식, 이형일, 김신향, 권태찬, 강진무
계명대학교 의과대학 소아과학교실
Clinical and epidemiological studies were conducted on 113 cases of miliary tuberculosis under the age of 15 years who were admitted to the Pediatric Department of Keimyung University Hospital for the past 15 years from January 1967 to December 1981. The results were as follows: There was no significant change in annual incidence. The majority of the patients(88%) were under the age of 6 years and the peak incidence were between 1 and 3 years of age group(35.4%). 50% of the cases were seen during spring season and the autumn had the least incidence. The source of the infection was found in 24.8% and 71.4% of them were from parents. Only 25.7% of the cases received BCG vaccination and 41.2% had negative result of tuberculin test. The chief complaints on admission were fever(83.2%), coughing(66.4%), vomiting(51.3%), dyspnea(25.7%) and convulsion(24.8%) in order. Hematologic findings on admission revealed mild degree of anemia in 64.6%, increased ESR in 48.6% and leukecytosis in 70% of cases. AFB smear and culture from sputum, gastric aspirates and spinal fluid indicated positive in 23.1%. Tuberculous meningitis was the most frequent complications of miliary tuberculosis noticed in 58.4% and most frequent between 1~3 yrs of age. Overall mortality was 28.3% but 20 cases among 28 expired cases complicated meningitis. Since 1976 there was tendency to decrease the mortality due to the improvement of therapy and the mortality was higher in the younger age group. There seems to be relatively lower mortality for the cases with negative tuberculin reaction and those who had BCGjnnoculation. Only 64 cases were possible to have complete follow up check with the consequence of 32 cases expiration.
Key Words: Miliary Tuberculosis

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