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Childhood Intra-thoracic Tuberculosis

  • Ben J. Marais
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 634)

Background

Tuberculosis (TB) has affected human kind for a very long time; archeological findings describe suggestive spinal changes in Neolithic man and conclusive evidence of tuberculous bone lesions have been found in mummified remains from Egypt, dating back to 3400 BC (Keers, 1978; Rubin, 1995). Hippocrates (460–377 BC) introduced the ancient Greek term for TB, phthisis, which became better known as consumption in the English world (Keers, 1978; Rubin, 1995). Although TB is an ancient disease it remains a major public health challenge. In fact, fuelled by poverty and rapid urbanization in developing countries, together with immune compromise resulting from human immunodeficiency virus (HIV) infection and emerging drug resistance, TB affects and kills more people today than ever before. The gravity of the situation is demonstrated by the fact that the TB epidemic continues to escalate, especially in sub-Saharan Africa, despite the declaration of a global TB emergency by the World...

Keywords

Tuberculin Skin Test Constrictive Pericarditis Positive Tuberculin Skin Test Hilar Adenopathy Tuberculous Empyema 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

I want to thank the childhood TB research team at the Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa, where most of the ideas presented here were developed. Also to the journals that permitted reproduction of previously published figures and images, including The International Journal of Tuberculosis and Lung Disease, Annals of Tropical Paediatrics and Pediatric Radiology.

References

  1. American Thoracic Society. Treatment of Tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994; 149: 1359–1374Google Scholar
  2. Andronikou S, Joseph E, Lucas S et al. CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 2004; 34: 232–236PubMedCrossRefGoogle Scholar
  3. Bentley FJ, Grzybowski S, Benjamin B. Tuberculosis in childhood and adolescence. The National Association for the Prevention of Tuberculosis. Waterlow and Sons Ltd, London 1954: 1–213 and 238–253Google Scholar
  4. Chintu C, Mudenda V, Lucas S et al. Lung diseases at necropsy in African children dying from respiratory illnesses: a descriptive necropsy study. Lancet 2002; 360: 985–990PubMedCrossRefGoogle Scholar
  5. Corbett EL. The growing burden of tuberculosis. Global trends and interactions with the HIV epidemic. Arch Intern Med 2003; 163: 1009–1021PubMedCrossRefGoogle Scholar
  6. Donald PR, Seifart HI. Cerebrospinal fluid concentrations of ethionamide in children with tuberculous meningitis. J Pediatr 1989; 115: 483–486PubMedCrossRefGoogle Scholar
  7. Donald PR, Sirgel FA, Venter A et al. The influence of human N-acetyltransferase genotype on the early bactericidal activity of isoniazid. Clin Infect Dis 2004; 39: 1425–1430PubMedCrossRefGoogle Scholar
  8. Du Toit G, Swingler G, Iloni K. Observer variation in detecting lymphadenopathy on chest radiography. Int J Tuberc Lung Dis. 2002; 6: 814–817PubMedGoogle Scholar
  9. Ellard GA, Humphries MJ, Allen BW. Cerebrospinal fluid drug concentrations and the treatment of tuberculous meningitis. Am Rev Resp Dis 1993; 148: 650–655PubMedCrossRefGoogle Scholar
  10. Ena J, Valls V, Short-course therapy with rifampin plus Isoniazid, compared with standard therapy with Isoniazid, for latent tuberculosis infection: a meta-analysis. Clin Infect Dis 2005; 40: 670–676PubMedCrossRefGoogle Scholar
  11. Goussard P, Gie RP, Kling S, Beyers N. Expansile pneumonia in children caused by Mycobacterium tuberculosis: clinical, radiological and bronchoscopic appearances. Pediatr Pulm 2004; 38: 451–455CrossRefGoogle Scholar
  12. Hesseling AC, Schaaf HS, Gie RP, Starke JR, Beyers N. A critical review of diagnostic approaches used in the diagnosis of childhood tuberculosis. Int J Lung Dis 2002; 6: 1038–1045Google Scholar
  13. Keers RY: Pulmonary tuberculosis: A journey down the centuries. London, Baillaire-Tindall, 1978Google Scholar
  14. Leung AN, Muller NL, Pineda PR, et al. Primary tuberculosis in childhood: radiographic manifestations. Radiology 1992; 182: 87–91PubMedGoogle Scholar
  15. Madhi S, Gray G, Huebner RE et al. Correlation between CD4+ lymphocyte counts, concurrent antigen skin test and tuberculin skin test reactivity in human immunodeficiency virus type 1–infected and uninfected children with tuberculosis. Pediatr Infect Dis J 1999; 18: 800–805PubMedCrossRefGoogle Scholar
  16. Marais BJ, Gie RP, Schaaf HS et al. The clinical epidemiology of childhood pulmonary tuberculosis—A critical review of the pre-chemotherapy literature. Int J Tuberc Lung Dis. 2004a; 8: 278–285Google Scholar
  17. Marais BJ, Gie RP, Schaaf HS et al. The natural history of childhood intra-thoracic tuberculosis—A critical review of the pre-chemotherapy literature. Int J Tuberc L Dis. 2004b; 8: 392–402Google Scholar
  18. Marais BJ, Gie RP, Schaaf HS, Starke JR et al. A proposed radiological classification of childhood intra-thoracic tuberculosis. Ped Rad 2004c; 33: 886–894Google Scholar
  19. Marais BJ, Donald PR, Gie RP, Schaaf HS, Beyers N. Diversity of disease manifestations in childhood pulmonary tuberculosis. Ann Trop Paed 2005a; 25: 79–86Google Scholar
  20. Marais BJ, Gie RP, Hesseling AC, Beyers N. Adult-type pulmonary tuberculosis in children aged 10–14 years. Pediatr Inf Dis J 2005b; 24: 743–744Google Scholar
  21. Marais BJ, Gie RP, Obihara CC, Hesseling AC, Schaaf HS, Beyers N. Well-defined symptoms have improved value in the diagnostics of childhood pulmonary tuberculosis. Arch Dis Child 2005c; 90: 1162–1165Google Scholar
  22. Marais BJ, Obihara CC, Gie RP, Schaaf HS, Hesseling AC, Lombard C, Enarson D, Bateman E, Beyers N. The prevalence of symptoms associated with pulmonary tuberculosis in the average child from a high-burden community. Arch Dis Child 2005d; 90: 1166–1170Google Scholar
  23. Marais BJ, Obihara CC, Warren RM et al. The burden of childhood tuberculosis—a public health perspective. Int J Tuberc Lung Dis 2005e; 9: 1305–1313Google Scholar
  24. Marais BJ, Gie RP, Hesseling AC, Schaaf HS, Enarson DA, Beyers N. Radiographic signs and symptoms in children treated for tuberculosis: possible implications for symptom-based screening in resource-limited settings. Ped Infect Dis J 2006a; 25: 237–240Google Scholar
  25. Marais BJ, Gie RP, Schaaf HS et al. A refined-symptom-based approach to diagnose pulmonary tuberculosis in children. Pediatrics 2006b; 118: e1350–e1359Google Scholar
  26. Marais BJ, Gie RP, Schaaf HS, Donald PR, Beyers N, Starke J. Childhood pulmonary tuberculosis—Old wisdom and new challenges. Am J Resp Crit Care Med 2006c; 173: 1078–1090Google Scholar
  27. Marais BJ, Gie RP, Schaaf HS, Hesseling AC, Enarson DA, Beyers N. The spectrum of childhood tuberculosis in a highly endemic area. Int J Tuberc Lung Dis 2006d; 10: 732–738Google Scholar
  28. Marais BJ, Hesseling AC, Gie RP, Schaaf HS, Beyers N. The burden of childhood tuberculosis and the accuracy of routine surveillance data in a high-burden setting. Int J Tuberc Lung Dis 2006e; 10: 259–263Google Scholar
  29. Marais BJ, Hesseling AC, Gie RP, Schaaf HS, Enarson DA, Beyers N. Bacteriologic yield in children with intra-thoracic tuberculosis. Clin Infect Dis 2006 f. 42: e69–e71Google Scholar
  30. Marais BJ, van Zyl S, Schaaf HS, van Aardt M, Gie RP, Beyers N. Adherence to isoniazid preventive chemotherapy in children: a prospective community based study. Arch Dis Child 2006 g; 91: 762–765Google Scholar
  31. Marais BJ, Wright C, Gie RP, Hesseling AC, Schaaf HS, Enarson D, Beyers N. Etiology of persistent cervical adenopathy in children: a prospective community-based study in an area with a high incidence of tuberculosis. Pediatr Inf Dis J 2006 h; 25: 142–146Google Scholar
  32. Marais BJ. Adult-type TB in children. Expertos Invitados—Sociedad Iberoamericana de Infromacion Cientifica 2007; www.siicsalud.com
  33. Marais BJ, Cotton M, Graham S, Beyers N. Diagnosis and management challenges of childhood TB in the era of HIV. Jnl Infect Dis 2007; 196 (Suppl 1): S76–S85CrossRefGoogle Scholar
  34. Marais BJ, Pai M. New approaches and emerging technologies in the diagnosis of childhood tuberculosis. Paediatr Respir Rev 2007; 8: 124–133PubMedCrossRefGoogle Scholar
  35. Nelson LJ, Wells CD. Global epidemiology of childhood tuberculosis. Int J Tuberc Lung Dis 2004; 8: 636–647PubMedGoogle Scholar
  36. Obihara CC, Beyers N, Gie RP et al. Inverse association between M. tuberculosis infection and atopic rhinitis in children. Allergy 2005; 60: 1121–1125PubMedCrossRefGoogle Scholar
  37. Osborne CM. The challenge of diagnosing childhood tuberculosis in a developing country. Arch Dis Child 1995; 72: 369–374PubMedCrossRefGoogle Scholar
  38. Pai M, Riley LW, Colford JM. Interferon-gamma assays in the immunodiagnosis of tuberculosis: a systematic review. Lancet Inf Dis 2004; 4: 761–776CrossRefGoogle Scholar
  39. Rubin SA. Tuberculosis—Captain of all these men of death. Rad Clin N Am 1995; 33: 619–639Google Scholar
  40. Schaaf HS, Michaelis IA, Richardson M et al. Adult-to-child transmission of tuberculosis: household or community contact? Int J Tuberc Lung Dis 2003; 7: 426–431PubMedGoogle Scholar
  41. Schaaf HS, Parkin DP, Seifert HI et al. Isoniazid pharmacokinetics in children treated for respiratory tuberculosis. Arch Dis Child 2005; 90: 614–618PubMedCrossRefGoogle Scholar
  42. Schaaf HS, Marais BJ, Hesseling AC, Gie RP, Beyers N, Donald PR. Drug-resistant tuberculosis in children: a comparison of two surveys. Acta Paediatr. 2006; 95: 523–528PubMedCrossRefGoogle Scholar
  43. Schaaf HS, Victor TC, Engelke E et al. Level of isoniazid resistance in children with drug resistant tuberculosis—implications for treatment. Eur J Clin Microbiol Infect Dis 2007; 26: 203–205PubMedCrossRefGoogle Scholar
  44. Starke JR. Pediatric tuberculosis: time for a new approach. Tuberculosis 2003; 83: 208–212PubMedCrossRefGoogle Scholar
  45. Theart AC, Marais BJ, Gie RP, Hesseling AC, Beyers N. Criteria used for the diagnosis of childhood tuberculosis at primary health care level in a high-burden, urban setting. Int J Tuberc Lung Dis 2005; 9: 1210–1214PubMedGoogle Scholar
  46. Van Zyl S, Marais BJ, Hesseling AC, Gie RP, Beyers N, Schaaf HS. Adherence to antituberculosis chemoprophylaxis and treatment in children. Int J Tuberc Lung Dis 2006; 10: 13–18PubMedGoogle Scholar
  47. Verver S, Warren RM, Munch Z et al. Proportion of tuberculosis transmission that takes place in households in a high-incidence area. Lancet 2004; 363: 212–214PubMedCrossRefGoogle Scholar
  48. Weber HC, Beyers N, Gie RP, et al. The clinical and radiological features of tuberculosis in adolescents. Ann of Trop Paediatr 2000; 20: 5–10CrossRefGoogle Scholar
  49. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. WHO/HTM/TB/2006.371. Geneva: Switzerland.Google Scholar
  50. Zar JZ, Hanslo D, Apolles P, Swingler G, Hussey G. Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet 2005; 365: 130–134PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Paediatrics and Child HealthFaculty of Health Sciences, Stellenbosch UniversitySouth Africa

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