Pulmonarytuberculosis

(PTB)EtiologyMycobacteriumtuberculosisTransitionsinChildhoodTuberculosis

Notinfected(50-70%)

Infected(30-50%)

Diseased(10-30%)Within2years(50%)Lifelong(50%)LatentTB(70-90%)Neverdevelopactivedisease(90%)Contactwithsmearpositiveindexcase

CommonclinicaltypesofpulmonaryTBinchildrenPulmonaryTBTBoftrachebronchiallymphnodesPrimarycomplexAcutemiliaryTBofthelungsPrimarypulmonaryTBThemaintypesofpulmonaryTBinchildren

1.Primary

complex：mostlyseeninyoungerchildrenBacillimultipliesandspreadvialymphaticscausinglymphadenopathyPrimarycomplex:

dumbbellshapelesions

lunglesion,lymphangitisandlymphadenopathy

Radiographscouldshowlungparenchymaldisease,lymphnodeenlargement1.Primary

complexDumbbellshapelesions：Lunglesion,Lymphangitis,Lymphadenopathy1.Primary

complexDumbbellshapelesions：Lunglesion,Lymphangitis,LymphadenopathyEnlargementoflunglymphnodesandmediastinallymphnodesCancausecompression2.TBoftrachebronchiallymphnodes2.TBoftrachebronchiallymphnodesEnlargementoflunglymphnodesandmediastinallymphnodes2.TBoftrachebronchiallymphnodesAconsequenceofprimaryorpostprimarydisease(3-6mslater)HematogenousdisseminationNodulesmeasuring2-3mmindiameterMoreinlowerlungzonesPerhapstheonlyradiographicfindingthatmaybehighlysuggestiveoftuberculosisininfantsandchildrenEasytoconcurrenttuberculosismeningitis3.AcutemiliaryTBofthelungs3.AcutemiliaryTBofthelungsMilletsamplenodules3.AcutemiliaryTBofthelungsMilletsamplenodulesTBtoxemiaRespiratorysymptomssymptoms(various)lowheat,fatigue,anorexia,nightsweats,angularCough,expectoration,hemoptysis,chestpain,breathingdifficultiesClinicalmanifestationsLungsignsisnotobviouslungraleSlowonsetHistoryTBtoxemiaPPDLaboratorytestsDiagnosisTBcontactBCGContagionEtiologyImmunological

testsESRImageexaminationGastricjuiceformycobacteriumtuberculosisPCRcultureTB-AgTB-Ab

TBactivityChestX-rayChestCTLaboratorytests:BronchoscopyObservelesionsGastricjuiceformycobacteriumtuberculosis123AcutebacterialpneumoniaCavitarylungabscessResponsetoantimicrobialdrugsFevercausedbysomeotherdiseasesDifferentialdiagnosisHistoryResponse

toantibioticsGermicultureImagingfeaturesDifferentialdiagnosis：SurgicaltherapySupporttherapyChemotherapyTherapyIntensivePhaseContinuationPhaseIsoniazid

RifampinPyrazinamide

Streptomycin2monthsIsoniazid

Rifampin4monthsTreatment:Short-termchemotherapyPhasesoftreatment:Theintensivephaseusuallycoversthefirst2monthsoftreatment.Duringthisphase,mostofthebacilliwillbekilled.Thecontinuationphase

usuallylasts4-6months,dependingonthetreatmentregimen.Thisphaseisintendedtoeliminatetheremainingdormantbacilli.Thesedormantbacillidecreaseconstantlyastreatmentintakeprogresses.Casereport

14-monthAsiangirl

3

weeks

cough

and

unwell

Admitted

to

local

hospital

With

mildfeverWithoutche