Tuberculosis

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

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 childrenand adolescents are asymptomatic. When disease does occur, clinicalmanifestations most often appear 1 to 6 months after infectionand include fever, growth delay or weight loss, cough, nightsweats, and chills. Pulmonary radiographic findings range fromnormal to diverse abnormalities, such as lymphadenopathy ofthe hilar, subcarinal, or mediastinal nodes; atelectasis orinfiltrate of a segment or lobe; pleural effusion; cavitarylesions; or miliary disease. Extrapulmonary manifestations aremeningitis and disease of the middle ear and mastoid, lymphnodes, bones, joints, and skin. Renal tuberculosis and reactivationor adult-type pulmonary tuberculosis are rare in young childrenbut can occur in adolescents. Clinical findings in patientswith drug-resistant tuberculosis are indistinguishable frommanifestations in patients with drug-susceptible disease.

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ETIOLOGY: The agent is Mycobacterium tuberculosis, an acid-fastbacillus (AFB). Human disease caused by Mycobacterium bovis,the cause of bovine tuberculosis, occurs in the United Statesin 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 contactwith a person with suspected or confirmed contagious pulmonarytuberculosis and who has a negative TST result, normal physicalexamination findings, and chest radiographic findings that arenot compatible with tuberculosis. Some exposed people have infection(and subsequently develop a positive TST result) and some donot; the . . . [Go to Full Text]

Related text in Red Book:

Summary of Major Changes in the 2003 Red Book: Red Book 2003: xxv. [Extract] [Full Version]
Active Immunization: Red Book 2003: 7-9. [Extract] [Full Version]
Tuberculin Testing: Red Book 2003: 36. [Extract] [Full Version]
Vaccine Safety and Contraindications: Red Book 2003: 37-49. [Extract] [Full Version]
Refugees and Immigrants: Red Book 2003: 92-93. [Extract] [Full Version]
Medical Evaluation of Internationally Adopted Children for Infectious Diseases: Red Book 2003: 173-180. [Extract] [Full Version]
Human Milk: Red Book 2003: 117-123. [Extract] [Full Version]
Children in Out-of-Home Child Care: Red Book 2003: 123-137. [Extract] [Full Version]
School Health: Red Book 2003: 137-146. [Extract] [Full Version]
Infection Control for Hospitalized Children: Red Book 2003: 146-155. [Extract] [Full Version]
Diseases Caused by Nontuberculous Mycobacteria (Atypical Mycobacteria, Mycobacteria Other Than Mycobacterium tuberculosis): Red Book 2003: 661-666. [Extract] [Full Version]
Measles: Red Book 2003: 419-429. [Extract] [Full Version]
Fluoroquinolones: Red Book 2003: 693-694. [Extract] [Full Version]

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