A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease.

Korean Journal of Pediatrics Pub Date : 2018-11-01 Epub Date: 2018-11-15 DOI:10.3345/kjp.2018.07206
Dongsub Kim, Sodam Lee, Sang-Hee Kang, Mi-Sun Park, So-Young Yoo, Tae Yeon Jeon, Joon-Sik Choi, Bora Kim, Jong Rim Choi, Sun Young Cho, Doo Ryeon Chung, Yon Ho Choe, Yae-Jean Kim
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引用次数: 1

Abstract

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals.

Methods: A 4-year-old child without Bacille Calmette-Guérin vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts.

Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB.

Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

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接触一名患有类似炎症性肠病的播散性肺结核的儿童后进行接触调查。
目的:结核病(TB)是引起幼儿死亡率和发病率的最重要疾病之一。关于受感染儿童传播结核病的数据有限。在此,我们报告了一例儿童播散性结核病例,并对接触者进行了接触调查。方法:1例未接种卡介苗-谷氨酰胺疫苗的4岁儿童被诊断为培养证实的播散性结核。儿童最初表现为炎症性肠病的症状,并报告了医院和幼儿园的暴露情况。将指示病例的接触者分为家庭接触者、医院接触者和幼儿园接触者3组。评估是按照韩国结核病指南进行的。幼儿园接触者进一步分为密切接触者和偶然接触者。对接触者进行胸片和结核菌素皮肤试验或干扰素- γ释放试验。结果:共检查327例(家庭接触者3例,医院接触者10例,幼儿园接触者314例),其中18例(5.5%)为结核潜伏感染(LTBI),其中17例为结核潜伏感染(LTBI)。在幼儿园与指示病例有密切接触的儿童中,LTBI的诊断更为频繁(17.1%比4.4%,P=0.007)。所有病例均无活动性结核。结论:这是韩国首例报道的儿童播散性结核病传播病例。应强调结核病是儿童慢性腹泻和发育不良的一个可能原因。一项国家结核病控制政策已被积极应用于识别韩国儿童LTBI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
0.00%
发文量
0
审稿时长
12 weeks
期刊介绍: Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.
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