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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Tuberculosis

Clinical Manifestations
Etiology
Definitions
Epidemiology
Diagnostic Tests
Treatment (see Table 3.69, p 649)
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Most tuberculosis infections in children and adolescents are asymptomatic. When disease does occur, clinical manifestations most often appear 1 to 6 months after infection and include fever, growth delay or weight loss, cough, night sweats, and chills. Pulmonary radiographic findings range from normal to diverse abnormalities, such as lymphadenopathy of the hilar, subcarinal, or mediastinal nodes; atelectasis or infiltrate of a segment or lobe; pleural effusion; cavitary lesions; or miliary disease. Extrapulmonary manifestations are meningitis and disease of the middle ear and mastoid, lymph nodes, bones, joints, and skin. Renal tuberculosis and reactivation or adult-type pulmonary tuberculosis are rare in young children but can occur in adolescents. Clinical findings in patients with drug-resistant tuberculosis are indistinguishable from manifestations in patients with drug-susceptible disease.


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ETIOLOGY: The agent is Mycobacterium tuberculosis, an acid-fast bacillus (AFB). Human disease caused by Mycobacterium bovis, the cause of bovine tuberculosis, occurs in the United States in children who have ingested unpasteurized milk or milk products.


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DEFINITIONS:

  • Positive tuberculin skin test (TST). A positive TST result (see Table 3.67, p 643) indicates likely infection with M tuberculosis. Tuberculin reactivity appears 2 to 12 weeks after initial infection; the median interval is 3 to 4 weeks (see Tuberculin Testing, p 645).

  • Exposed person refers to a patient who has had recent contact with a person with suspected or confirmed contagious pulmonary tuberculosis and who has a negative TST result, normal physical examination findings, and chest radiographic findings that are not compatible with tuberculosis. Some exposed people have infection (and subsequently develop a positive TST result) and some do not; the . . . [Go to Full Text]