Tuberculose doença – Casuística de um serviço de pediatria no século XXI

Abstract

Introduction: Tuberculosis is a leading cause of world-wide mortality and morbidity. A reduced rate of tuberculosis in people aged less than 15 years has been seen in Portugal over the last decade of the twentieth century.Material and methods: Retrospective analysis of tuberculosis cases in children admitted to the Centro Hospitalar de Vila Nova de Gaia January 1 2000 to December 31 2007. The individual epidemiological, clinical, radiological, microbiological and treatment information was analysed.Results: We found 23 cases of tuberculosis disease (78% pulmonary tuberculosis and 22% extra-pulmonary tuberculosis). Children’s ages varied from 6 months to 16 years, with the male gender predo-minant. All patients had previously been vaccinated with BCG and there was a prior contact with TB in 57%. 2007 was the year with the highest number of cases. The Mantoux test was positive in 91% cases and M. tuberculosis isolation was possible in 61%. Gastric fluid analysis allowed isolation in 1/3 of cases and bronchoscopy contributed to M. tuberculosis isolation in 43% cases with negative gastric fluid analysis. Every patient underwent at least 6 months of tuberculostatic treatment, without any documented resistances.Conclusion: Tuberculosis remains a real problem, with the diagnosis, the search for contacts and adequate treatment (including prophylaxis) the main challenge.Rev Port Pneumol 2009; XV (5): 771-782