Pediatric Oncall最新文献_第8页

Clinical profile of Tuberculous Pleural Effusion in Children 儿童结核性胸腔积液的临床分析

Pediatric Oncall Pub Date : 2021-08-27 DOI: 10.7199/ped.oncall.2022.13

Ankita Shah, Sunayna Gurnani

{"title":"Clinical profile of Tuberculous Pleural Effusion in Children","authors":"Ankita Shah, Sunayna Gurnani","doi":"10.7199/ped.oncall.2022.13","DOIUrl":"https://doi.org/10.7199/ped.oncall.2022.13","url":null,"abstract":"Aim: To determine the age distribution, clinical and laboratory findings, and outcomes of patients with tuberculous pleural effusion (TPE). Methods: This retrospective study was done over a period of 5 years in children between 1 month -15 years of age who were referred to our tertiary referral center with TPE. Results: Seventy-six (5.3%) children were diagnosed with pleural effusion of which 43 (56.6%) patients had right-sided affection, 31 (40.8%) had left sided affection and 2 (2.6%) bilateral involvement. Mean age of presentation was 6.8±3.2 years. Mean ADA values in pleural fluid were 107.6±115.7 IU/L. High ESR was found in 58 (77.8%) with mean values of 79.1±28.5 mm at end of 1 hour. Left sided effusion was seen at a mean age of 7.9±3.5 whereas right sided effusion was seen at a mean age of 6.1± 2.8 (p=0.016). Conclusion: Most of the pleural effusions are seen in children < 10 years of age and does not have a predilection for adolescents as mentioned in literature. Elevated ADA and ESR may suggest TPE. Though right sided effusion is more common, left sided effusion is seen in older children. Introduction Tuberculosis (TB) is most common cause of infections related death globally. It is estimated that childhood TB constitutes 10–20% of all TB in high-burden countries.1 Tuberculous pleurisy is the second most common form of extrapulmonary tuberculosis (TB)2 and a common cause of pleural effusion in endemic TB areas. There is limited data regarding the prevalence of tuberculous pleural effusion (TPE) in children but estimated literature has shown that frequency of pleural involvement in pediatric tuberculosis ranges from 238%.3,4,5,6 Effusion is not a common characteristic of primary pulmonary TB in young children and it is more probable to be detected in adolescents and adults.7 The aim of this study was to describe the age distribution of pediatric patients with TPE, with the clinical and laboratory findings and outcome of these patients. Methods & Materials This was a retrospective study done over 5 years in children between 1 month -15 years of age who were referred to our tertiary referral center. Patients identified as TPE were included in the analysis. TPE was diagnosed if the chest radiograph depicted a pleural effusion and at least one of the following criteria: (1) positive culture or positive cartridge based nuclear acid amplification test (CBNAAT) or presence of acid-fast bacilli (AFB) for Mycobacterium tuberculosis (MTB) from pleural fluid, (2) Compatible clinical picture with pleural fluid showing lymphocytic predominance or levels of adenosine deaminase activity (ADA) more than 35 IU/l with/without a positive tuberculin skin test or contact with an adult having TB. Records of all patients were evaluated and clinical history; examination findings and laboratory investigations were noted. Malnutrition was defined as weight or height less than 3 centile as per Agarwal charts.8 Associated ser","PeriodicalId":19949,"journal":{"name":"Pediatric Oncall","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87114559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}