| Clinical Review of Tuberculosis in Childhood. |
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Hye Ran Lee, Woon Sik Kim, Don Hee Ahn, Keun Chan Sohn |
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Department of Pediatrics, National Medical Cemter Seoul, Korea. |
| 소아 결핵에 대한 임상적 고찰 |
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이혜란, 김운식, 안돈희, 손근찬 |
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국립의료원 소아과 |
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| Abstract |
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A clinical review was made on 152 cases of tuberculosis who had been admitted at pediatric department, National Medical Center during the period of 10 years from January, 1969 to December, 1978.
The following results were obtained. 1.There noted no difference of annual incidence throughout the study years. 2. The highest age incidence was in the group of 1 to 3 years and more than half cases were under 3 years of age. 3.Seasonal distribution showed somewhat increased incidence in spring and winter. 4. Socio-economical background showed that the most patients belonged to low socio-economic class. 5. Pulmonary lesion was found in 129 cases, that was 84.2% of 152 patients,and meningitis 44.1%, pleurisy 15.1% and followed by intestine, bone & joint, kidney, lymphnode and pericardial lesion in order of frequency.6. Contact history with tuberculosis patients in the family could be found in 28. 9% of the patients. Father was the most common source and mother, grand-parents, relatives and siblings were in order of frequency. 7. Fever was the most common chief complaint on admission(73. 3%),and then cameheadache (34.9%), vomiting (33.6%) and loss of appetite in that orders. 8.Tuberculin test showed 93.2% of positive rate. 9.B.C.G. was done in 23% of the patients. In B.C.G. vaccinated group, extensive-tuberculosis such as meningitis or miliary tuberculosis occured less frequently compared to non-vaccinated group. 10. On laboratory data, anemia was not common(20. 8%), mild leuaocytosis was found in. about 45.6% and elevated erythrocyte sediment rate was found in about 48.2%. 11. Microbiologic study revealed 16.9% of positive data to Mycobacterium tuberculosis. Positive rate was 4.3% with smear only, which increased to 21.8% with culture. Therefore culture method seemed more reliable than smear.
12. Chest X-Ray showed abnormal findings in 98.5% of the patients. Right side was more commomly affected than the left but both lungs were involved in most cases. 13.One hundred and tweleve cases were treated with triple drugs (INH, PAS, streptomycin, and in other cases ethambutol or rifampin or both were added instead of PAS. With above regimen 57.0% of the patients were cured and mortality rate was 13.2%. Mean duration of
the treatment in the cured cases was 19 months.
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| Key Words:
Childhood tuberculosis, BCG vaccination, Tuberculin test, Extrapulmonary tuberculosis |
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