Tuberculosis is a disease that is predominantly transmitted by airborne droplets. Its causative agent is Koch's bacillus. Tuberculosis can be called a social disease, because 80% of patients have a fairly low standard of living.
IN modern world It is not at all necessary to live on the street to get tuberculosis; everyone is at risk - both children and adults.
Tuberculosis in children is more severe than in adults. This is due to the fact that children are much more susceptible and weaker. It is about childhood tuberculosis that we will talk today. Let's find out what pulmonary tuberculosis is in children, how it develops and how it is treated.
Factors of infection and development of the disease
It is quite easy for a child to become infected with tuberculosis. The main route of infection is contact with the sputum of a sick person with an open form of the disease. When coughing, the patient sprays particles of sputum around himself, which fall on the people around him and settle on the floor and furniture.
A child can become infected by inhaling contaminated air, through contact with contaminated things, or by consuming contaminated products. Most often, the bacillus enters the child’s body through the oral cavity, but in rare cases, a transplacental route of infection is also possible.
The child’s mother must be extremely careful, follow all the doctor’s recommendations, and then the child has every chance of growing up completely healthy. Thus, the causes of tuberculosis in children are few - usually it is a simple disregard for hygiene or contact with an infected person.
Stages of the disease in children
Once in the body, the Koch bacillus affects the cells of the immune defense, and then the tissues of the body. T-lymphocytes also begin to work actively, but they are weak and die quickly.
As a result, it is through the fault of T-lymphocytes that necrotic tissues are formed, which are an excellent environment for the development of the disease.
Cells pass through the capillaries, which help the formation of tuberculous granulomas, increasingly expanding the focus of inflammation. The affected tissues die.
The body responds to MBT with tuberculous inflammation caused by three components:
- exudative;
- proliferative;
- damaging.
Each of these components is characterized by an individual process. During exudation, they leave the vessels cellular components, during proliferation they grow, and at the stage of destruction, cheesy necrosis is formed. These processes occur regardless of the form and location of the disease. Below we will look at the phases of tuberculosis in more detail.
Phases of tuberculosis during primary infection
At first, infection practically does not manifest itself in any way. Clinically, signs are either very scarce or non-existent. During this period, pathogens enter the lymphatic system and organs of immunogenesis. It is at this time that the reaction to Mantoux becomes positive.
This is followed by a pre-allergic period (lasting 2 weeks), during which antibodies are formed. Despite the presence of Koch bacillus in the body, Mantoux is often negative.
The allergic period is characterized by fixation of infection on the organs of immunogenesis (these include the spleen, bone marrow, liver, lymph nodes). Lymphocytes accumulate around the office. There are no signs of intoxication yet, there is no damaging component, but the lymph nodes are already enlarged.
With proliferation, the number of lymphocytes around the office increases. They prevent the growth of the destructive process. The higher the immunity, the greater the number of lymphocytes “protecting” the infection. After six months, the destruction of surrounding tissues begins and a caseous-necrotic (destructive) component appears. Intoxication is still mild.
1 year after infection, mininecrosis with miniproliferation (proliferation of surrounding tissues) is observed, which is caused by each of the rods that enter the body.
Intoxication is pronounced, Mantoux is positive. Local forms of tuberculosis appear in children and adolescents, which treatment helps prevent. A sick child should visit a pediatric TB specialist.
If tuberculosis in a child subsides, points of caseous necrosis remain on his organs (lungs, bronchi, intestines, bones, lymph nodes), where inflammation was previously localized, which can become the cause of newly developed tuberculosis in adulthood. This trend is observed in 90% of cases.
Due to external factors that reduce the strength of the immune system, it begins to react to the presence of mycobacteria in the body, sending there certain families of lymphocytes, namely macrophages. They begin to absorb harmful bacteria, but die, releasing special enzymes.
The latter liquefy the caseous tissue. With pulmonary tuberculosis, mycobacteria are released into the tissue and then into the surrounding space, and the patient becomes pathologically dangerous to other people.
Reversal of the disease
The healing process occurs after treatment or without it, if the sick child has enough strong immunity. In this case, the decay cavities begin to shrink and close, being replaced by scars. The process subsides and the infection stops its development (usually this occurs at 3, 4 and 5 years).
During the fight against MBT, lymphocytes begin to damage healthy tissue. In response, the body produces antipreases.
This process can be balanced, but if the immune system cannot cope, then the cirrhotic form of pulmonary tuberculosis begins.
Primary and re-infection
Like adults, childhood tuberculosis can have various shapes, depending on the time it develops in the child. Each of the forms has its own subtypes, but not all of them develop in children or develop quite rarely. Therefore, we will limit ourselves to describing the most common types of each form of tuberculosis in children and adolescents.
General symptoms
First 1-2 weeks symptoms acute illness resemble symptoms of a cold. If they do not go away after 3 weeks, there is a risk of developing the disease. During the first 3 weeks, children suffer from a dry cough, but why does it start? wet cough with pinkish discharge.
Among the main signs of tuberculosis in children are:
Other symptoms that can be confused with other diseases include:
- when the meninges are damaged, convulsions, headaches, and vomiting are observed;
- intestinal tuberculosis is manifested by indigestion, vomiting, blood in the stool;
- tuberculosis of bones and joints causes pain when moving, increases the risk of fractures and lameness;
- tuberculosis of the genitourinary system manifests itself with lower back pain, high fever, pain during urination and blood in the urine;
- the skin affected by the infection is thickened, the lymph nodes enlarge and rot, tearing the membrane.
How do the forms of the disease manifest themselves in children?
Pulmonary tuberculosis in children of the primary form occurs in the vast majority of infected people, in contrast to the secondary form, the occurrence of which in children is quite rare. For children under 2-4 years of age, pulmonary tuberculosis is especially dangerous and is much more difficult to tolerate than in adults.
In the period up to 4-7 years, the tendency to extensive infection is especially pronounced, since the effect of the BCG vaccination weakens by this time, so complications are often observed. However, even under such conditions, with primary tuberculosis there is a high chance of the lesion shrinking or completely disappearing.
Tuberculosis of the intrathoracic lymph nodes is a primary infection. It is diagnosed in 80% of children with this disease. Specific changes are little pronounced, therapy gives positive dynamics. The tumorous (tumor-like) form has a more severe course and is more common in children early age(up to 4-6 years).
Secondary tuberculosis is diagnosed in adolescents not so often; as a rule, these are young people who suffered a primary infection in childhood. It usually coincides with puberty and is diagnosed at 13-14 years of age. The symptoms coincide with the primary genesis. Infiltrative and focal pulmonary tuberculosis predominates.
Disseminated tuberculosis is rare in children and adolescents. It is preceded by a primary infection with a breakthrough of the lesion into the blood with sensitivity of the vascular system. The main reason for the appearance of this form is an endogenous decrease in immunity.
In early adolescence, the infection often occurs in the form of miliary tuberculosis, which also affects other organs along with the lungs.
The subacute form develops as the primary infection subsides, but sometimes manifests itself as a secondary form.
The chronic form of disseminated tuberculosis acquires fibrotic and tricky features, with seasonal exacerbations. Its outcome is usually unfavorable. Tuberculous pleurisy, which also sometimes occurs as a complication of secondary tuberculosis in a teenager, can be a complication of tuberculosis of the intrathoracic lymph nodes or a separate disease.
Separately, it is worth mentioning extrapulmonary tuberculosis. Studies have shown that over the past 15 years the percentage of extrapulmonary forms of the disease has decreased. In young children (from 1 to 5-7 years), tuberculitic meningitis and tuberculosis of the central nervous system are most often diagnosed, and in adolescents - tuberculosis of the peripheral lymph nodes and genitourinary system.
Treatment and prevention
Are vaccinated children at risk of infection? This vaccination does not protect the child from infection, but it significantly reduces this risk and does not allow the disease to pass from a closed form to an open one, and also helps to avoid severe complications in case of infection.
A vaccine with a weakened virus allows the body to develop immunity without infecting the child. Many doctors recommend vaccinating children, despite the presence of preservatives in the vaccine.
There are two types of treatment for tuberculosis in children and adolescents:
A doctor should advise how to treat a child if there is a tuberculosis infection. It has been noticed that children who began treatment in a timely and correct manner often recover, since their tissue regeneration occurs faster.
The consequences of tuberculosis, if detected in the later stages, are very severe and can lead to serious complications and even fatal outcome. The consequences of treatment for tuberculosis, which sometimes lasts two to three years, can be both positive and negative. Chemotherapy in 15% of cases causes a side effect - toxic or allergic. Children who are at risk often suffer from it - with chronic diseases, overweight, prone to allergies.
The peculiarity of tuberculosis in children, first of all, is its danger to health. As mentioned above, in children under 5 years of age, the tuberculosis bacillus causes more complications than in older children. However, in addition to age, factors such as poor nutrition, lack of vitamins, stress and lack of sleep play a major role in the development of the disease.
In conclusion, I would like to say that, despite the seriousness of this disease, it is always possible to cure a child. The main thing is to constantly monitor his health, regularly check for tuberculosis, not self-medicate and strictly follow the doctor’s recommendations.
Tuberculosis in children begins with severe weakness. Children gain weight poorly and become overly irritable. If a student falls ill, parents may notice a decrease in academic performance, poor perseverance and inattention. The temperature rises to low-grade levels, although it is often higher. Inflamed The lymph nodes, they become dense and large. When conducting a tuberculin test, the answer is always positive. All these signs indicate that Koch’s bacillus has entered the body, which leads to severe intoxication. Children are often diagnosed with chronic tuberculosis intoxication. If parents notice the symptoms of the disease in a timely manner and consult a doctor, the prognosis is very good. With adequate treatment, the child’s body copes well with this infection.
First signs
The first signs of tuberculosis in children may resemble a respiratory disease, so parents do not take them seriously. Such signs include elevated temperature, hysterical cough, severe weakness and apathy. If such symptoms do not disappear within a few weeks, but rather worsen, then tuberculosis can be suspected.
At the early stage of tuberculosis in children, some symptoms are very specific and characteristic of all forms of this disease:
- Sudden weight loss.
- Enlarged lymph nodes.
- Weakness, apathy and irritability.
- Poor appetite.
- Abnormal sweating, which is often accompanied by chills.
If the pathology has become chronic, then other symptoms appear.
- The child is developmentally behind his peers.
- The skin becomes pale and dry to the touch.
- Sleep is disturbed.
- The liver is noticeably enlarged.
- The child is in a state of mild euphoria.
In addition, childhood tuberculosis also has specific symptoms of the disease, which can be used to determine where the source of infection is localized. The most common form of tuberculosis is pulmonary, it occurs with the following characteristic symptoms:
- Abnormal weakness - the child looks tired even after a night's sleep, school performance worsens, appetite decreases and absent-mindedness is observed.
- Unhealthy appearance - the patient is excessively thin and pale, he has an unhealthy blush and a painful shine in his eyes.
- Elevated temperature – the temperature remains subfebrile for a long time or episodes of causeless increases in temperature to high levels are periodically observed. Mostly, hyperthermia occurs at night, and the child sweats a lot and suffers from chills.
- An important symptom of early stage pulmonary tuberculosis in children is a cough that does not go away for more than 3 weeks. It starts out dry and then becomes wet.
Another sign of tuberculosis infection is coughing up blood. If parents notice that there is blood in the sputum that the child coughs up, they must urgently call an ambulance. This sign indicates the onset of pulmonary hemorrhage, which poses a great threat to the patient’s life.
If a child begins to lose weight for unexplained reasons, parents should tell the doctor. This phenomenon may be the first sign of tuberculosis.
Signs of the disease in children under one year of age
Infancy, according to medical concepts, lasts up to one year. Tuberculosis at this time can be either acquired or genetic.
Symptoms of tuberculosis in infants may vary slightly, but there are basic signs that should make parents suspect something is wrong.
- Deterioration of health – lethargy, apathy, sleep and appetite disturbances.
- Breathing problems. In infants, this may manifest as periodic bouts of coughing or choking.
- Retraction chest on the part of the lungs - such a deviation can be noticed by the doctor by conducting a special test.
A sick child quickly loses weight, this is especially noticeable if the baby is not yet 3 years old and his body weight is already small.
The baby refuses to eat, has a hard time crying, and does not actively respond to the appearance of his parents or new toys. The cough becomes more intense and frequent, which disturbs sleep.
Tuberculosis in infants is especially dangerous. This is explained by the fact that the disease is not always diagnosed on time, so treatment begins untimely and the recovery period is delayed.
Symptoms in preschool children
In children over 5 years of age, symptoms are more pronounced. In addition, preschoolers can already tell their parents what worries them and where it hurts. The first symptoms of the disease in such children do not indicate infection of the lungs. Most often there is a deterioration in health. The child complains of weakness, he becomes less active and does not want to participate in outdoor games. After a while, parents may notice that the baby has lost his appetite, and he sleeps very restlessly. The baby's weight gradually decreases.
Next comes cough, shortness of breath and other symptoms of tuberculosis in children, which indicate a problem with the respiratory organs. Parents may notice that one part of the sternum seems to be sunken. This indicates damage to the respiratory organs on that side.
A sick child is placed in hospital treatment and any contact with other people is limited. The diagnosis can only be confirmed by conducting a detailed examination. For this, x-rays, the Mantoux reaction, a detailed blood test and some other diagnostic methods can be used.
Tuberculosis is still considered dangerous disease which can lead to the death of a child. Parents should understand that the earlier the disease is diagnosed, the better the prognosis.
Symptoms in teenagers
Symptoms of tuberculosis in children 7 years of age and adolescents are somewhat different from signs of the disease in infants and preschoolers. The main symptoms of tuberculosis in adolescents are as follows:
- Severe weakness and apathy are quickly accompanied by pain in the sternum.
- Coughing attacks become more frequent and intense.
- There is shortness of breath. Moreover, it happens even in a state of complete rest. This greatly disrupts the child's life.
In older children, parents notice changes in the shape of the breasts. It becomes sunken or one section of the sternum sinks in on the side of the affected organ.
Changes are also observed on the skin. The epidermis becomes thin and vulnerable. On different parts bodies often appear unexplained wounds and abrasions. Hemoptysis and enlarged lymph nodes are often observed.
To diagnose the disease, a special test is often performed. The same tests are done periodically at all stages of treatment.
Other signs of tuberculosis
Pulmonary tuberculosis in children is usually very severe, but the infection can also affect other organs, which is manifested by characteristic symptoms.
Signs of tuberculosis of other forms at the most early stages in children can be confused with other pathologies, so when making a diagnosis, the doctor must consider all possible options for the disease:
- If tuberculosis has affected the membrane of the brain, then a depressive state is observed. As the disease progresses, these symptoms include dizziness, nausea and frequent seizures. The disease, detected at a late stage, is very difficult to cure. There is a high probability of death. Most often, this pathology is observed in children whose family has a person infected with Koch's bacillus.
- Tuberculosis of the digestive system is manifested by dyspeptic symptoms. This may include constipation or frequent diarrhea, blood in the stool and unexplained vomiting. With this form of the disease, the temperature can rise to high levels.
- Tuberculosis of joints and bones is manifested by limited mobility, pain with any movement, as well as fairly frequent fractures. If the disease is not cured in a timely manner, the patient begins to limp over time.
- Tuberculosis of the genitourinary organs is accompanied by severe pain in the back and pain when urinating. Blood streaks are found in the urine.
- With skin tuberculosis, there is a significant increase in lymph nodes, the appearance of seals on the skin and abscesses. With this form of the disease, the skin becomes thinner, so abrasions are often observed.
Only an experienced doctor can make a correct diagnosis. If you have tuberculosis, it is strictly forbidden to self-medicate; all actions must be agreed upon with a TB doctor.
Girls who suffered from tuberculosis of the genitourinary system in childhood may be infertile in adulthood!
Types of tuberculosis in children
In young children, not only pulmonary tuberculosis is often diagnosed, but also other forms of this dangerous pathology. Tuberculous meningitis, miliary tuberculosis, primary tuberculosis complex and many other forms of the disease can be diagnosed. The main cause of the disease is considered to be contact with an infected person and lack of BCG vaccination.
Meningitis caused by Koch's bacillus
In this form of the disease, the membranes of the brain are affected. In children, the disease is extremely severe and progresses rapidly. There are regular headaches, lethargy and sudden mood swings. If this form of tuberculosis in children is not treated, then after two weeks the patient’s condition becomes very serious. The child often begins to vomit, have problems with bowel movements, inflamed eyes and a very slow pulse.
If Koch's bacillus leads to meningoencephalitis, then certain areas of the brain that are responsible for different functions are affected. In this case, to make a diagnosis, it is necessary to do a cerebrospinal fluid analysis and be sure to computed tomography. Tuberculous meningitis often occurs in conjunction with other pathologies, so when diagnosing the disease, the doctor must conduct a series of studies to identify viruses and pathogenic fungi in the body.
Full recovery usually takes more than a year. During this time, the child is in the hospital several times and undergoes complex treatment. Treatment is required accompanying pathologies, If there are any. The most important component of treatment is sanatorium-resort therapy. Children after tuberculosis are sent to health resorts, which are located in coniferous forests or not far from them.
During the recovery period after tuberculosis, the child should eat well and walk a lot. fresh air. The baby must be protected from various infections.
Primary tuberculosis complex
This condition occurs with high fever, severe cough and chest pain. Breathing is very difficult, shortness of breath is observed. The child has a decreased appetite and a noticeable loss of strength. When listening, wheezing is detected from the source of infection. The disease is confirmed based on x-ray and computed tomography data.
The infection can be transmitted from a sick person to a healthy person. It is worth considering that Koch's wand is quite tenacious. Treatment is carried out using special medications and physiotherapeutic procedures.
In this form of the disease, the body is extensively affected by the tuberculosis bacillus. The disease is very severe, mainly affecting the respiratory organs, spleen and urinary tract. There are two forms of miliary tuberculosis.
- Acute sepsis – traditional methods tests do not help diagnose the disease. The symptoms are quite vague, so most often the patient dies within a couple of weeks from the onset of the disease.
- Acute miliary tuberculosis - manifests itself acute intoxication and difficulty breathing. The patient has a high temperature. Initially, the infection is localized, but if treatment is not carried out, extensive damage occurs.
If a patient with this form of tuberculosis undergoes an ultrasound internal organs, then there is a noticeable increase in the liver and spleen. Blood and urine tests are required to assess the condition of the whole body. With this form of the disease, tuberculin tests often show false data.
Is this form of tuberculosis curable in children? Yes, this disease can be treated, but the patient must take several anti-tuberculosis drugs at the same time, which are very toxic. At the same time, physiotherapy is carried out, immunomodulators and vitamin complexes are prescribed. Duration similar treatment is at least six months.
Young children are more susceptible to miliary tuberculosis than adolescents and adults. In them, the infection affects small areas of the organs.
Tuberculosis of the thoracic lymph nodes
In this form of the disease, the respiratory organs are extensively affected. The disease occurs with weight loss, poor appetite, excessive nervous excitement and decreased motor activity. The main symptoms include insomnia and abnormal sweating, especially at night.
To diagnose the disease, the patient is sent for X-rays of the respiratory organs and blood tests. In the first three months of treatment, strong anti-tuberculosis drugs are used. If the prescribed therapy is effective, then after a while the doctor may reduce the amount of medications the patient takes.
Tuberculosis of peripheral lymph nodes
The nodes that are most susceptible to infection are those located in close proximity to the neck. They become mobile and painful, often filled with necrotic mass. When the lymph node is heavily filled with pus, it ruptures and in its place a purulent fistula forms, which scars a little later. The body temperature may be more than 40 degrees, the patient is bothered by headaches and general weakness.
For diagnosis, a fluid sample is taken from the affected lymph node, a chest x-ray is taken, and a tuberculin test is performed.
Treatment for this form of the disease can be medication or surgery. To speed up recovery, lymphotropic therapy can be used. This treatment method minimizes the risk of relapse.
Prevention of tuberculosis in children consists of timely BCG vaccination. The first vaccination is carried out in the maternity hospital, and revaccinations, according to indications, are given at 7 and 14 years of age. Parents should monitor the health of their children and immediately consult a doctor at the slightest suspicious symptoms. It must be remembered that tuberculosis is easier to treat in the early stages.
Each stage has its own coloring and manifestations.
Exactly at childhood a person is faced with this pathology because the baby’s immune system is not fully formed.
According to statistics, subsequent infections in older age do not pass without a trace for a person, which cannot be said about a childhood disease.
Therapist: Azalia Solntseva ✓ Article checked by doctor
Symptoms and first signs of tuberculosis in children
Symptoms of the disorder depend on the type of illness the child has, as well as his age. The most common is pulmonary tuberculosis.
The form of pathology with extrapulmonary lesions occurs in approximately 20-30% of all cases. Tuberculous meningitis is more common in children under 3 years of age.
Infants and young children are at particular risk of developing severe, widespread, and often fatal disease, which may manifest as a miliary (systemic) infection. Adolescents are exposed to adult-type pathology.
In children with pulmonary tuberculosis, the most common symptoms are a chronic cough that lasts more than 21 days, fever, weight loss, or developmental delays. Other manifestations are nonspecific.
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Signs of tuberculosis in the early stages
Initial symptoms and signs may appear differently for each child. Everything depends, first of all, on his age.
The most common first signs of tuberculosis in children in the early stages in babies under one year of age:
- cough;
- fever;
- chills;
- increase in the size of the tonsils;
- growth slowdown;
- weight loss.
The most common first symptoms of tuberculosis in children under 3 years of age are:
- chest pain;
- cough lasting more than 3 weeks;
- blood in sputum;
- fever;
- night sweats;
- chills;
- swollen tonsils;
- weight loss;
- weakness;
- decreased appetite;
- fatigue.
Manifestations of the disease may simulate other health conditions. It is important to seek medical help if such symptoms occur.
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Ways of infection of babies under one year old
Tuberculosis occurs when babies inhale bacteria spread by infected people. The microorganism grows and is transferred to the intracellular environment, where it may remain metabolically inactive for many years before reactivation and onset of disease.
Pathogenicity (pathogenicity) is the ability of a pathogen to cause disease. In this pathogen, this ability is manifested in its impact on immune reactions: incomplete phagocytosis of macrophages and delayed immune allergic reactions.
A child becomes infected with tuberculosis in basically the same way as an adult, when they come into contact with mycobacteria that are in the air. The source of infection for children is usually adults with active disease, in which the cough is contagious. Great importance has transmission in public places such as schools and kindergartens.
Once bacteria enter the lungs, they can multiply and then spread through blood vessels to nearby lymph nodes. Several weeks after the initial infection, the child develops an immune response.
In most children, the body's defense system stops tuberculosis bacteria from further development and spread, although microorganisms often manage to survive the primary immune reaction.
The risk of progression of the pathology is greatest when the child is under three and a half years old, and to a lesser extent when he is under ten. There is also a greater risk of infection spreading in babies with weakened immune systems, for example if they are HIV-infected.
Typically, within two years after the initial infection, the child develops an active form of the disease. In a small number of older children, the pathology develops later, either due to reactivation after an inactive period or as a result of reinfection.
Lymphohematogenous spread, especially in young patients, can lead to miliary tuberculosis, with caseous material reaching the bloodstream from the primary site. Meningitis can also be a consequence of this process.
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Types of disease in children 3.5 years old
The disease is divided into two large type: pulmonary and extrapulmonary. They, in turn, are divided into several subgroups, depending on the damage to organs or systems.
Endobronchial tuberculosis with lymphadenopathy is a common type of pulmonary tuberculosis. The symptoms result from pressure on various structures from the enlarged lymph nodes. A persistent cough results in symptoms suggestive of bronchial obstruction, while difficulty swallowing may result from compression of the esophagus.
Pleural effusions (accumulation pathological fluid V pleural cavity in inflammatory processes) usually occur in older children and are rarely associated with miliary disease. The medical history reveals an acute onset of fever and chest pain that worsens with deep inspiration.
Elevated body temperature usually persists for 14-21 days. Progression of the pulmonary parenchymal component can lead to pneumonia and atelectasis.
It is more common in young children than in teenagers. The child develops symptoms of fever, cough, malaise, and weight loss.
Patients with peripheral lymphadenopathy (a form of extrapulmonary tuberculosis) may have a history of enlarged nodes. Fever, weight loss, fatigue, and malaise are usually absent or minimal.
The main symptom appears 6-9 months after the initial infection with bacilli. Common sites of involvement include the anterior cervical, submandibular and supraclavicular, inguinal, or axillary lymph nodes.
One of the most serious complications of the pathology is tuberculous meningitis, which develops in 5-10% of children under the age of 2 years; after this the frequency drops to 1%. The subacute process begins within 3-6 months after the primary infection.
Nonspecific symptoms such as anorexia, weight loss and fever may be present. After 1-2 weeks, patients may experience vomiting and seizures or changes in consciousness. May get progressively worse mental status, up to coma and death, despite quick diagnostics and early intervention.
There are three stages of tuberculous meningitis:
- The first stage is determined by the absence of focal or generalized neurological signs. Only nonspecific behavioral abnormalities are diagnosed.
- The second stage is characterized by a stiff neck, altered tendon reflexes, lethargy, or cranial nerve palsies.
- Third and The final stage, includes major neurological defects: coma, seizures, and abnormal movements (eg, choreoathetosis, paresis, paralysis of one or more limbs). Patients with tuberculomas or brain abscesses may have focal neurological signs depending on the location of the bacteria.
Miliary tuberculosis is a complication of the primary form in young children. May present with low-grade fever, malaise, weight loss, and fatigue.
Skeletal tuberculosis can occur acutely or subacutely. Spinal lesions may not be detected for months to several years due to slow progression.
Common pathological sites include large supporting bones, vertebrae, hips and knees. Bone deformation is a late sign of the disease.
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Correct medical diagnosis
Detection of the disease in children is difficult due to nonspecific and variable clinical and radiographic signs, especially in patients younger than 4 years and in those with HIV infection. Diagnosis of tuberculosis in children and treatment of the inactive form of the pathology are important to reduce the risk of developing active tuberculosis, since the disease often occurs in a latent form.
Until 2001, the tuberculin skin test was the only commercially available immunoassay to identify infection. It is used all over the world to diagnose any form of disease, but has some limitations.
It should be administered properly using the Mantoux method, consisting of an intradermal injection of 0.1 ml of tuberculin-produced protein derivative antigen into the forearm area. Although positive results usually associated with increased risk worsening of a current or future disorder, the test may also give false positives in BCG vaccinated individuals.
Due to these limitations, interferon-gamma expression assays have been developed that also detect pulmonary pathology. These new tests evaluate drug release in response to synthetic overlapping peptides directed against mycobacteria.
These proteins are absent in BCG vaccine strains, so the analysis is much more accurate than the standard one. To perform the test, fresh blood from the patient is collected and mixed separately with reagents and then incubated for 16-24 hours.
To make a diagnosis of congenital tuberculosis, children and adolescents must have proven lesions and at least one of the following:
- conclusion about tuberculosis infection of the placenta or maternal birth canal;
- eliminating the possibility of postnatal transmission;
- the presence of a primary infectious complex in the liver;
- skin lesions during the first week of life, including papular defects or petechiae.
Sputum samples can be used in older children (6 years and older). Before this age, the cough is not productive enough to produce mucus for analysis. Nasopharyngeal secretions and saliva have no diagnostic value.
Gastric aspirates are used instead of sputum in children under 6 years of age. Since gastric acidity is poorly tolerated by tuberculosis bacilli, neutralization of the removed sample must be carried out immediately. Even with the right technique, microorganisms can only be detected in 70% of infants and 30-40% of children.
Mycobacteria increase serum antibody levels. However, serodiagnostic tests for tuberculosis have not yet been developed that have adequate sensitivity and specificity for routine use in diagnosing the disease in children.
www.ncbi.nlm.nih.gov
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Effective treatment of the disease
Anti-tuberculosis drugs kill mycobacteria, thereby preventing further complications of the early primary disease and progression of the pathology, protecting the child’s body from infection.
First of all this:
- rifampin (rifampicin),
- isoniazid,
- pyrazinamide,
- ethambutol
- streptomycin.
Secondly, the following are used:
- capreomycin,
- ciprofloxacin,
- cycloserine,
- ethionamide,
- kanamycin,
- ofloxacin,
- levofloxacin
- para-aminosalicylic acid.
Recommendations for the treatment of pulmonary tuberculosis include a 6-month course of isoniazid and rifampin, which should be supplemented with pyrazinamide for the first 2 months. Ethambutol is allowed to be included in the initial regimen until the results of drug susceptibility studies are available.
Most cases outside pulmonary form, including cervical lymphadenopathy, can be treated using the same regimens that are used to treat the primary pathology. The exceptions are diseases of bones and joints, miliary pathology and meningitis. For such severe forms The recommended regimen is 2 months of isoniazid, rifampicin, pyrazinamide, and streptomycin once daily, followed by 7–10 months of only the first two medications once daily.
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Rehabilitation period and prevention
The key method of preventing the disease is prompt identification and treatment of patients with tuberculosis. Childhood tuberculosis is extremely dangerous. The primary symptom of the disease often does not appear in the early stages.
Thorough training in adherence to therapy, side effects medications and follow-up care is an important part of the fight.
Adults with a positive tuberculin skin test result, clinical or radiographic manifestations, receiving therapy with this drug, do not get sick in 54-88% of cases, while children are 100% protected.
BCG is available for the prevention of disseminated tuberculosis. It is a live vaccine obtained from weakened strains of mycobacteria.
The most important role of vaccination is to prevent serious and life-threatening diseases such as miliary tuberculosis and mycobacterial meningitis in children. The BCG vaccination does not prevent tuberculosis infection.
The key method in the rehabilitation of patients after illness is:
- active lifestyle,
- active games in the fresh air,
- maintaining adequate sleep and wakefulness.
Tactics of long-term bed rest and minimal physical activity, which was used previously, has not proven its effectiveness. When infections affect the body, it is necessary to deal not only with treating the disease, but also strengthening immune system.
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356 10/03/2019 5 min.Tuberculosis in children is a particularly dangerous infectious disease that affects not only the lungs. It is in early childhood that infection with Koch's bacillus, which is the main causative agent of the disease, often occurs. If the child is not vaccinated, after completion incubation period so-called “primary” tuberculosis develops. Preventive diagnostics will help to identify and treat tuberculosis in a timely manner. First of all, this is the annual Mantoux test. In the article, consider the first symptoms of tuberculosis.
Tuberculosis in children - definition of the disease, stage and form
The name "tuberculosis" comes from Latin word"tuberculum", which literally means "tubercle". This is due to the fact that the specific form of the disease leads to the appearance of characteristic tumors on the skin, similar to tubercles. The most common form of the disease is pulmonary. In more rare cases, the infection spreads to other organs: eyes, skin, bones, intestines, and others.
Tuberculosis can occur in open or closed form. In the first case, the child is contagious, since the infection can be spread by airborne droplets with sputum or saliva. This does not happen with a closed form.
Tuberculosis responds well to treatment, which allows the child to fully recover. This significantly reduces the risk of secondary tuberculosis, when a person gets sick again after some time. Not always, after a tuberculosis bacillus enters a child’s body, this leads to illness. A large number of people may simply be carriers of the infection. If the child’s body is weakened, this leads to the appearance of primary symptoms of tuberculosis.
It is in children that any form of tuberculosis is more severe than in adults. This is due to the fact that the child’s immature immune system does not cope well with the infection.
Tuberculosis is an extremely contagious disease, so all children under 18 years of age should have a Mantoux test done annually. If the result is positive, you will need comprehensive examination all family members. In this case, the child must be observed in a tuberculosis clinic for a year, after which the next Mantoux test is done. You may also need preventative treatment with. The same preventive measures are needed if the child communicated with an already sick person or a carrier of infection.
One of the most effective measures tuberculosis prevention is vaccination. BCG vaccination done on the 3rd – 7th day of the child’s life, and then again at 7 and 17 years old. This will create stable immunity and reduce the risk, even if the child meets a carrier of tuberculosis.
Causes and treatment
Tuberculosis is an acute infectious disease, the causative agent of which is always Koch's bacillus. It is better known as the “tuberculosis bacillus”, because it is the one that causes tuberculosis in 100% of cases.
You can become infected with tuberculosis through contaminated foods or objects. Sometimes it is enough to stay in the room where the sick person was before, even for a short time.
There are factors that provoke the development of tuberculosis in children:
- Unfavorable social conditions;
- Poor environmental conditions;
- Unbalanced diet;
- "Passive smoking;
- Frequent stress.
The risk group includes children with chronic diseases or congenital pathologies: type 1 diabetes mellitus, lung diseases, of cardio-vascular system and others. Children also at risk include:
- Under 3 years of age;
- Having been infected with tuberculosis in the past;
- Having congenital immunodeficiency;
- Undergoing treatment with medications that reduce immune activity;
- Those who are in close contact with a patient with tuberculosis.
Contact with a person who has an open form of tuberculosis creates the maximum risk of pulmonary tuberculosis in the future. That is why prophylaxis primarily prevents infection with the tuberculosis bacillus.
Symptoms and first signs
If the child is not vaccinated against tuberculosis or has a weakened immune system, then after a period of 3 to 12 weeks, primary symptoms may appear. The danger is that the disease may not manifest itself in any way for the first 2–3 weeks. Because of this, parents discover signs of infection with tubercle bacilli too late. The first symptoms that appear can easily be confused with normal symptoms.
In order to detect the disease on time, it is important to carry out preventive diagnostics. For children, this is an annual Mantoux test.
The first symptoms of tuberculosis:
- Temperature 37.2 - 37.5 C, which lasts longer than 2 weeks;
- Severe physical fatigue;
- Lethargy;
- Poor sleep;
- Decreased appetite;
- Sudden weight loss, weight loss;
- Enlarged lymph nodes;
- Night sweats.
The child often becomes absent-minded and loses interest in learning. If preventive treatment is not started immediately, more serious symptoms will soon appear:
- Dyspnea;
- With copious discharge sputum;
- Blood in sputum;
- Chest pain that occurs during coughing or at rest.
When the first signs appear, you need to consult a phthisiatrician. A comprehensive examination will be required not only of the child himself, but also of all family members.
Types and classifications
The most common type of tuberculosis is the pulmonary form. Children also have bronchial glands. There is also a disseminated form of pulmonary tuberculosis. It is quite rare, since it simultaneously leads to damage to the liver, spleen and peripheral lymph nodes. With a weak immune system, the infection from the lungs enters the bloodstream, spreading throughout the body.
Primary tuberculosis most often provokes foci of infection in the lung tissue.
If the infection spreads throughout the body, the following types of tuberculosis occur:
- Tuberculosis of the lymph nodes;
- Tuberculosis of bones or joints;
- Tuberculosis of the genitourinary system;
- Lupus;
- Miliary tuberculosis (small foci of infection throughout the body);
- Tuberculosis of the meninges.
If a child encounters an infection for the first time, we are talking about primary tuberculosis. If, after complete recovery, he becomes infected again, this is secondary tuberculosis. According to the severity of tuberculosis, it can be:
- Spicy;
- Subacute.
Also, any of them can occur in such forms as:
- Open;
- Closed.
The most dangerous is the open form of the disease, in which a person is extremely contagious. Treatment should be carried out only in a hospital setting. The closed form of the disease is milder and is diagnosed faster. At the same time, a sick person is not contagious to others, although he is a carrier of the infection.
The closed form of the disease often occurs hidden and can only be diagnosed by a doctor.
Sources of infection for pneumonia
Most often, the tuberculosis bacillus is transmitted by airborne droplets. The tuberculosis bacillus is an incredibly resilient bacterium that can live outside the human body. It remains active in the air, soil and dried sputum of a sick person. Moreover, it is even resistant to many disinfectants.
Sources of infection can be:
- A person with active pulmonary tuberculosis;
- Any objects touched by a sick person;
- Products infected with tuberculosis bacillus (for example, milk from a sick cow).
You can become infected during everyday contact with a sick person: through shared dishes, towels, kisses.
A child can get an infection in the prenatal period if the mother is a carrier of tuberculosis.
Video
Useful video about tuberculosis in children
conclusions
Tuberculosis for children is a much more serious disease because it affects not only the lungs. Tuberculosis of the meninges, or tuberculous meningitis, is much more common in children. Chronic intoxication that accompanies this disease in a child makes its course more severe than in an adult. The main task of parents is to monitor the child’s condition and, if there are any suspicious symptoms, show him to the doctor.
Tuberculosis remains one of the most common infectious diseases. The disease poses a threat not only to adults, but also to children and adolescents. The causative agents of tuberculosis infect the human respiratory system and affect almost all organs. Tuberculosis is a very insidious disease; its development occurs in an imperceptible manner. Therefore, you should know the causes and symptoms of the disease in order to prevent serious consequences. This is especially true for parents who must monitor the health of their children.
How does infection occur?
Tuberculosis is an infectious disease transmitted by contact with the wet secretions of a sick person. A child can catch an infection anywhere public place or when constantly being near a patient in the active phase of tuberculosis.
The pathogen penetrates the alveoli respiratory system. Macrophages then absorb the tuberculosis infection. Mycobacteria begin to penetrate the lymphatic system. Through the bloodstream, the infection spreads to other organs.
Bacteria prefer to multiply in organs that contain oxygen. Primarily these are the respiratory tract, urinary and central nervous system. The time from the moment the bacteria enters the body to the onset of the first symptoms is from 14 days to 3 months. An infected child poses a threat to the health of others over a long period of time. While tuberculosis is in the active phase of spreading. This period lasts until the start of treatment.
But it should also be taken into account that some people may be asymptomatic carriers of bacteria for a long time. For now, tuberculosis infection is contained by the immune system. For some, it is so strong that upon contact with mycobacteria a person does not become infected.
Main reasons
The tuberculosis bacterium, referred to as the “Koch bacillus,” enters the body and gradually affects the site of its dislocation. The main route of infection is airborne. But there are many other options for infection. A larger percentage of children were infected due to some interaction with a sick person. When talking, sneezing, coughing, the mycobacterium got into the air, and the child inhaled sputum containing the pathogen. After which Koch’s wand ended up right in the lungs.
Other causes of infection include:
- entry of bacilli into gastrointestinal tract. This can happen when eating food of animal origin (dairy products from a sick cow);
- infection of the mucous membrane of the eye;
- placental infection. A sick mother carrying a child can transmit the virus to him through the placenta. This can also happen if it is damaged during labor;
There are a number of factors leading to the development of the disease among children. A weakened immune system plays a major role in this. Causes of poor immunity in children:
- susceptibility to diseases from birth;
- the presence of other infections in the body;
- frequent stress;
- unbalanced diet.
Every person has the opportunity to become infected. But children living in inappropriate conditions are most susceptible to this.
Signs of tuberculosis in children
In a sick child, multiple symptoms of the disease can be observed. At the first stage of tuberculosis development, these are signs of intoxication of the body. The rate at which it will appear depends on the number of mycobacteria that have entered the child’s organs. When the bacilli just begin their journey through the body, the following are more obvious:
- weakness of the whole body;
- slight fever that does not subside for a long time;
- loss of interest in food;
- weight loss;
- hyperhidrosis;
- feeling tired;
- mental retardation;
- the skin is white.
Problems in the area are also highlighted psychological state child. Constant mood swings, increased heart rate, sweaty hands.
home distinguishing feature The symptoms of tuberculosis from acute respiratory infections are that they manifest themselves very slowly. Acute respiratory diseases actively manifest themselves in the early stages of infection.
Previously, one of the signs of tuberculosis infection was fever. Now this symptom is absent in most cases.
Primary symptoms
The very first sign– this is a specific reaction of the body to the causative agent of tuberculosis. The primary stage provokes the production of antibodies. They, in turn, influence mycobacteria, which from the blood enter the cells of the immune system. Macrophages are found in almost all human organs. It is because of this location that signs of infection can appear in any organ.
This immune system reaction does not last long. In children it may go away within a month. But getting rid of symptoms is not a cure. Treatment of tuberculosis in children can take a very long time.
Primary stage pathologies occurring in the child’s body:
- Inflammation around the eyes. Redness of the eyelids and eyeball appears. These signs appear both in combined form and separately. Excessive tear production is observed. Intolerance to bright light develops. With such symptoms, before testing for tuberculosis, consultation with an ophthalmologist is required.
- The appearance of arthritis.
- Skin covering is also subject to symptoms of intoxication. Redness appears in the shape of a circle. They are located mainly on the shins. Sometimes manifestations occur on the arms or hip areas. Therefore, examinations of the child must be carried out over the entire skin.
- Swelling of the lymph nodes. This process is absolutely painless. Several nodes are affected at once, and they become mobile. At first, the lymph nodes are soft. As the disease progresses, they harden.
This reaction is not characterized inflammatory process due to bacterial infection. This is a collection of cells in one of the human organs. Consequence of contact with infection.
How tuberculosis manifests itself in children in various forms
Each form of tuberculosis infection has its own symptoms and manifestations in children. Let's look at each in more detail.
Primary tuberculosis
Manifestations of tuberculosis infection in the primary form are distinguished by their invisibility. Almost half of infected children show no obvious physical signs. The newborn is more likely to exhibit physical symptoms. But they are most often implicitly expressed.
Cough without sputum production– the most common symptom of tuberculosis among children.
In rare cases, it may appear fever. Weight loss and a feeling of fatigue in the body are also possible. Problems with gaining the required body weight mainly occur in newborns. It will disappear only after high-quality treatment with drugs.
Symptoms in the respiratory system are even less common. Newborns and children after one year sometimes develop characteristic wheezing. When inhaling, noises in the lungs may be heard. Rapid breathing or partial cessation of pulmonary blood flow is observed. All of these symptoms may disappear with the use of antibiotics. This suggests that, along with the causative agents of tuberculosis, there is also a bacterial infection in the body.
Reactive tuberculosis
This type of tuberculosis almost never occurs in children. preschool age. Even children who had tuberculosis in infancy can in very rare cases be susceptible to a reactive form. This type mainly appears in children after reaching the age of seven. When infected with a primary infection. This species is located in the respiratory system. It cannot continue to develop in other organs due to the immune system fighting the pathogen.
Among teenagers, the following symptoms are observed:
- fever;
- weakness of the whole body;
- cough with sputum production;
- weight loss;
- pain in the chest area.
All manifestations of reactive tuberculosis gradually disappear with the beginning of the treatment process. Noticeable improvements in the child's condition occur after a few weeks. However, the cough may persist for up to several months. This type of tuberculosis is very dangerous for a healthy person. The risk of infection from a patient is very high.
With the right and timely treatment the patient is completely freed from the disease.
Pericarditis
The disease affects the sac that contains the heart. For children, this form of tuberculosis is not typical or occurs in very rare situations. The symptoms are not very different from other types of the disease (slight increase in temperature over a long period of time, weakness, weight loss). Painful sensations in the chest area in children is not observed.
Lymphohematogenous tuberculosis
When they enter the lymphatic system, mycobacteria begin a “journey” throughout the child’s body. The intensity of the spread depends on the number of bacteria entering the blood, as well as the resistance of the immune system.
With such a spread, there are practically no symptoms observed. But the process itself may come with some complications. A fever indicates that bacteria have entered the bloodstream. This symptom lasts quite a long time.
Often, various organs are involved in this process. The most common are: liver, spleen, lymph nodes, kidneys. The consequence of such participation is an increase in the size of the affected organ. Damage may affect bones and joints. Inflammation of the brain occurs already at the last stage of the disease. The organs of the respiratory system suffer to a lesser extent with this form of tuberculosis. Only when bacteria remain in the lungs for a long time does a diffuse change become noticeable.
Miliary form of tuberculosis
One of the types of disseminated tuberculosis. Formed when a large number of pathogens enter the circulatory system. The lesion forms in several organs at once. It occurs as a result of complications of the primary stage of the disease, which lasts for half a year from the date of infection. This type is most common in children. But teenagers are also no exception; miliary tuberculosis occurs as a consequence of a previously caused infection.
The initial manifestations of the miliary type of disseminated tuberculosis are pronounced. After just a few days, the person becomes seriously ill. Development is accompanied by an increase in body temperature and loss of kilograms. There are no formations on the skin. Enlargement of the lymph nodes, spleen and liver occurs approximately 2 weeks after intoxication. This occurs in almost half of all patients with this diagnosis.
The more intense the disease develops, the more stable the febrile state becomes. In this case, an X-ray examination shows the absence of pathologies in the chest area. Respiratory signs are subtle or non-existent. For about two more weeks, pathogens accumulate in the lungs. Afterwards, coughing and hoarseness begin to appear.
For the first time, an X-ray examination can detect foci of inflammation when their size reaches only 2 mm. After which small lesions begin to merge and form large pathologies. 
Symptoms of brain damage are observed in about a third of patients with active disease. Constant or variable headaches indicate the presence of meningitis. Painful sensations in the stomach indicate the development of tuberculous peritonitis. Primary rashes on the skin followed by spread throughout the body are papulonecrotic tuberculosis. Its symptoms can also be seen in miliary tuberculosis.
Treatment of this form proceeds at a very slow pace. Even if you follow all the instructions of specialists and select quality drugs. Feverish manifestations disappear no earlier than 3 weeks after the start of therapy. The first positive results in the area of accumulation of lesions appear after several months or more.
If the disease was detected on initial stage and intensive chemotherapy was performed, then the chance of recovery tends to 100%.
Damage to the upper respiratory tract. Tuberculosis of the hearing organ
Pathology of this type is practically not observed in people living in developed countries. The same cannot be said about countries with less developed living conditions. Laryngeal tuberculosis is most common in children. Signs are: cough with sputum production, painful sensations in the throat area, difficulty swallowing.
Common signs of ear disease:
- noise effects in the hearing organs;
- formation and release of fluid from the auricle;
- partial facial paralysis;
- pathology of the eardrum.
Tuberculosis of lymph nodes
This form of tuberculosis infection is the second most common form of tuberculosis infection after pulmonary lesions.
A characteristic sign is an increase in the volume of lymph nodes . The process occurs gradually from one week to several months. When light pressure is applied to the enlarged lymph node, the patient feels discomfort. In some cases, at a late stage of the development of the disease, an increase in temperature, loss of body weight, and hyperhidrosis are observed, mainly at night.
At the early stage of the disease, the lymph nodes are soft and mobile. The skin over them is not changed. Then adhesions appear between the nodes, and the skin gradually becomes inflamed. In the final stages, cell death begins in the lymph nodes. When touching them, the patient feels pain. Due to their large volumes, lymph nodes can put pressure on neighboring organs.
Tuberculous lesion of the central nervous system
Central tuberculosis nervous system the most serious complication for a child. If treatment is not started in time, its development leads to death.
Pathology in the brain is a consequence of the spread of the pathogen through the blood and lymphatic system. Metastases appear in the cerebral cortex. Their intensity depends on the metastatic lesion of the meninges.
Complication of meningitis occurs when running forms tuberculosis in children.
This happens most often with children aged 5 months to 4 years. In some situations, the development of meningitis is possible some time after infection. The clinical picture of the disease can develop slowly or at an accelerated pace. The accelerated process appears mainly in infants. Signs appear literally a couple of days before acute form diseases.
Symptoms are divided into 3 stages:
First stage. Lasts about 2 weeks. Characterized by the following symptoms:
- fever;
- pain in the head area;
- depression;
- weakness and malaise;
Young children may experience developmental delays. Loss of acquired skills and abilities.
Second stage. It appears with intense speed. Symptoms:
- malaise, lethargy, weakness of the whole body;
- limb spasms;
- cardiopalmus;
- vomit.
The course of the disease in its active form leads to the formation of hydrocephalus. There is an increase intracranial pressure, as well as vascular inflammation. In some cases, the child does not show symptoms of hydrocephalus. Instead, encephalitis develops: impaired coordination of movements, incoherent speech and loss of orientation in space.
Third stage. The most dangerous stage with severe symptoms.
- coma;
- partial or complete paralysis of the limbs;
- high blood pressure;
- loss of essential reflexes.
Ultimately, the third stage leads to death in the absence of emergency care. Among such patients, even after complete recovery, various disorders in the central nervous system are observed, including mental retardation.
Tuberculosis of the skeleton
Basically, this complication process affects the spine. Occurs mainly in children. Bone pathologies are similar to fungal infections.
Skeletal damage occurs at a late stage in the development of tuberculosis. Therefore, now it practically does not arise. Thanks to developments to combat tuberculosis in the early stages.
Gastrointestinal tuberculosis
This disease develops quite rarely. The most common symptoms: the formation of ulcers in the area of the mucous membranes of the mouth (tonsils). Possible enlargement of regional lymph nodes.
Tuberculosis of the digestive system in children occurs in rare cases. Typically, this development occurs as a result of a pulmonary infection or penetration of the pathogen into the esophagus (swallowing the patient’s saliva). But education, regardless of the pulmonary form, is also likely.
Congenital form of tuberculosis
Signs of the congenital form in most cases become visible several weeks after birth. The following symptoms are identified:
- disturbances in lung function;
- temperature increase;
- refusal of food;
- weakness;
- irritability;
- bloated belly;
- inflammation of the skin;
- developmental delay.
The manifestation of symptoms depends on the area of the lesion and its size.
Diagnostic measures
To date, many diagnostic methods have been developed. Here are the highest quality ones:
- Mantoux test. To conduct this study, the patient is injected under the skin with a drug containing low dose pathogens of tuberculosis. The injection is absolutely safe for a healthy person. Looking at the injection site, the specialist diagnoses the body’s readiness to confront Mycobacterium tuberculosis. The event is held for children every year. Diaskintest can be used as an analogue.
- Fluorography. Thanks to radiation, it is possible to view the condition of the lungs.
- X-ray examinations. If, when undergoing the methods listed earlier in a person, a suspicion of infection is detected, then radiography is additionally used. To confirm or refute a diagnosis.
- Bacteriological diagnostics. An analysis of the patient's cough is performed to determine the degree of infectiousness of the patient. Screening is widespread in European countries.
- Bronchoscopy. The most difficult research method with very accurate diagnosis. Therefore, it is carried out in extreme cases. Provided that all other methods were useless.
For the correctness and accuracy of the results, at least two examinations should be completed.
Prevention of disease in children
Due to the fact that the number of tuberculosis patients increases every year, preventive measures among children are a necessity.
It is always easier to prevent a disease than to undergo long-term treatment later.
In medicine, a number of measures have been developed to prevent tuberculosis:
- BCG vaccine. Preventive method against tuberculosis in children. Particularly effective when used for newborn babies. It is carried out in almost all countries of the former CIS. BCG vaccination It is mainly administered to children on the 3rd day after birth. The procedure is performed only on healthy babies. A sick child is given an injection immediately after adjustment at the place of residence. A second vaccination is given to children who have reached the age of seven. Revaccination is carried out exclusively for healthy children. Therefore, before the procedure, it is mandatory to undergo a Mantoux test or Diaskintest. Injections in adolescence have been abolished by the state. Because by the age of 14 there remains a small number of uninfected children. Not long ago, developed countries put forward a proposal to revaccinate young people aged 18, but subject to first passing the Mantoux test.
- Fluorography. The sooner a person learns about the presence of a disease in his body, the higher the chances of a favorable outcome and the minimum likelihood of infection healthy people, and most importantly, small children. It is in order to avoid unpleasant consequences that all people over 16 years of age need to be examined. IN populated areas with a low probability of infection, adults should undergo fluorography at least once every 2 years. Where the risk of infection is higher, it is recommended to be examined once a year.
- Specialized institutions. For high-quality and effective treatment of patients, special hospitals (TB dispensaries) have been created. They provide complete isolation of infected people from healthy people. Hospitals involve isolating not only the infected, but also the source of the spread of tuberculosis pathogens. Such activities primarily protect the health of children. Preventive measures are regulated by law in all countries.
A set of measures to deal with the source of infection is also provided:
Treatment of the patient's place of residence with disinfectants. Conducted by a special sanitary service. The event involves the disinfection of all items without exception that a patient with tuberculosis has interacted with (mattress, dishes, curtains, furniture, etc.). Ultraviolet disinfection is carried out.
Preventive measures for children in contact with the sick person
- X-ray of the respiratory organs;
- checking the Mantoux reaction, carried out without queue;
- blood and urine tests;
- other examinations. Prescribed by a doctor in accordance with the child’s complaints.
Children with an increased risk of infection are examined every six months. The duration is determined by the condition of the patient nearby. Even after the death of the infected child, observation of the child continues for two years. The death of a patient from tuberculosis is due to the release of a large number of mycobacteria.
Preventive measures are provided for children who are close to the patient. with a special drug isoniazid. A whole course of taking the drug is recommended. The dose is calculated according to weight. The use of the drug lasts about six months. A specialist may prescribe isoniazad in combination with other drugs. Then the duration of prophylaxis is about three months.
If the pathogen is resistant to the drug, it is not prescribed, but additional examinations a child at the site of infection. Tests are taken after three months, and then every 6 months.
On this moment in developed countries, for children at increased risk of infection, there are health centers. In them, children undergo a thorough examination and qualified assistance.
Individual prevention for children implemented by parents
- providing balanced food for the child. The entire complex of vitamins, especially calcium, must be included in the diet;
- in the first time after the birth of the baby, you should avoid appearing with him in public places;
- do not allow the child to communicate with someone infected with tuberculosis. You should also not come into contact with a person whose cough has not gone away for a long time;
- maintaining a normal lifestyle for the whole family;
- child physical education classes;
- avoid hypothermia;
- carrying out measures to prevent the child from developing bad habits (smoking, alcohol and others);
- regular visits to a pediatrician in case of infection with acute respiratory infections and acute respiratory viral infections;
Tuberculosis infection in children is not an ordinary cold or runny nose that will go away in a week. Can't be neglected preventive measures, as well as knowledge of the symptoms of the disease. After all, as you know, a negligent attitude towards the disease leads to disastrous consequences. And it doesn’t matter whether the child is sick or healthy, it is the duty of every parent to take care of his well-being. Don't put your children in danger.
