True about childhood tuberculosis is?
ANSWER: (C) Diagnosis by sputum is difficultREF: Park 22nd ed page 178PEDIATRIC TUBERCULOSIS:Prevelance of childhood TB is between 10 to 20% of all TB cases and between 5 to 15% overallFrequency of childhood Tb depends upon: number of infectious cases, closeness of contacts, age of child when exposed, age structure of populationChildren are rarely sputum positive and non infective to othersChildhood tuberculosis is rarely contagious because; of low bacterial load and rarity of cavitating diseaseChildhood TB is common due to failure of control in adult and risk of infection to child depends upon extent of exposure to droplet nucleiAn infant with sputum positive mother has high chances of developing TBRisk of developing disease is greatest shortly after infectionChildren below 5 years of age are most susceptible because of poor immune system , therefore most common in age group of 1-4 yearsYoung age is a risk factor for dissemination to other body partsChildren (especially below 5 years of age) usually cannot expectorate sputum to allow a definite diagnosisAs there are no specific symptoms and findings on clinical examination in children, the diagnosis is usually made after taking history of close contact with an adult with TB, failure to thrive, and persistent cough > 3weeks if the child has received broad spectrum antibiotics.Tuberculin test may have supportive evidenceChest X ray is a common investigation, especially in military TBA Symptomatic child with tuberculin positive 10 mm , is considered as case regardless of BCG administration.For infants , if mother or any house hold member is smear positive, chemoprophylaxis is given for 3 months. Do a mantoux at 3 months, if positive, continue medicines for 6 months, if negative, stop medicine and give BCG if not given before.
5% prevalence
Common in 5-8 years age
Diagnosis by sputum is difficult
Highly contagious
Disorders of the Respiratory Tract