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Section 3. Summaries of Infectious Diseases

Tuberculosis

Clinical Manifestations
Etiology
Definitions
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Most infections caused by Mycobacterium tuberculosis and Mycobacterium bovis in children and adolescents are asymptomatic. When tuberculosis disease does occur, clinical manifestations most often appear 1 to 6 months after infection and include fever, growth delay, weight loss or poor weight gain, cough, night sweats, and chills. Radiographic findings in M tuberculosis infection range from normal to diverse abnormalities, such as lymphadenopathy of the hilar, subcarinal, paratracheal, or mediastinal nodes; atelectasis or infiltrate of a segment or lobe; pleural effusion; cavitary lesions; or miliary disease. Radiographic findings in M bovis infection can include the same pulmonary manifestations as M tuberculosis, extensive cervical and mesenteric lymphadenopathy, bowel wall thickening, and multiple enteric fistulae. Extrapulmonary manifestations of M tuberculosis disease include meningitis and granulomatous inflammation of the lymph nodes, bones, joints, skin, and middle ear and mastoid. Renal tuberculosis and progression to disease from latent tuberculosis infection or adult-type pulmonary tuberculosis are rare in young children but can occur in adolescents. In addition, chronic abdominal pain with intermittent partial intestinal obstruction can be present in disease caused by M bovis. Clinical findings in patients with drug-resistant tuberculosis disease are indistinguishable from manifestations in patients with drug-susceptible disease.

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ETIOLOGY: The agent is M tuberculosis, an acid-fast bacillus (AFB). Human disease caused by M 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 3.69, p 680) indicates possible infection with M tuberculosis or M bovis. Tuberculin reactivity appears 2 to 12 weeks after initial infection; the median interval is . . . [Go to Full Text]

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Introduction

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