ad
This Article
Right arrow Images Only
Right arrow Full Version
Services
Right arrow E-mail this link to a friend
Right arrow Related text in Red Book
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Articles in Pediatrics
Right arrow reprints & permissions
Right arrow Section 1
Section 2
Section 3
Section 4
Section 5
Appendices

The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Tuberculosis

Clinical Manifestations
Etiology
Definitions
Epidemiology
Diagnostic Tests
TREATMENT (SEE Table 3.82, P 688)
Isolation of the Hospitalized Patient
Tuberculosis Caused by M bovis
Control Measures

Top
 Next
See Images

CLINICAL MANIFESTATIONS

Tuberculosis disease is caused by infection with organisms of the Mycobacterium tuberculosis complex, which includes M tuberculosis, Mycobacterium bovis, and Mycobacterium africanum. M africanum is rare in the United States, and clinical laboratories do not distinguish it routinely. M bovis can be distinguished routinely, and although the spectrum of illness that is caused by M bovis is similar to that of M tuberculosis, the epidemiology, treatment, and prevention are distinct. Most infections caused by M tuberculosis complex 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, weight loss, or poor weight gain and possibly growth delay, cough, night sweats, and chills. Chest radiographic findings after 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. Extrapulmonary manifestations 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 ("adult-type pulmonary tuberculosis") are unusual in younger 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.


Top
 Previous
Next
See Images

ETIOLOGY

The agent is M tuberculosis complex, a group of closely related acid-fast bacilli (AFB): M tuberculosis, M bovis, and M africanum.


Top
 Previous
Next

Definitions


Related text in Red Book:

Summary of Major Changes in the 2009 Red Book

Red Book 2009: XXIX. [Extract] [Full Version]  

Active Immunization

Red Book 2009: 9-12. [Extract] [Full Version]  

Tuberculin Testing

Red Book 2009: 37-38. [Extract] [Full Version]  

Reporting of Adverse Events

Red Book 2009: 42-51. [Extract] [Full Version]  

Tuberculosis

Red Book 2009: 181. [Extract] [Full Version]  

Human Milk

Red Book 2009: 118. [Extract] [Full Version]  

Transmission of Infectious Agents via Human Milk

Red Book 2009: 119-124. [Extract] [Full Version]  

Children in Out-of-Home Child Care

Red Book 2009: 124. [Extract] [Full Version]  

Recommendations for Inclusion or Exclusion

Red Book 2009: 127-131. [Extract] [Full Version]  

Infectious Diseases—Epidemiology and Control

Red Book 2009: 131-138. [Extract] [Full Version]  

Infections Spread by the Respiratory Route

Red Book 2009: 142-143. [Extract] [Full Version]  

Infection Control for Hospitalized Children

Red Book 2009: 148-149. [Extract] [Full Version]  

Diseases Caused by Nontuberculous Mycobacteria

Red Book 2009: 701-708. [Extract] [Full Version]  

Measles

Red Book 2009: 444-455. [Extract] [Full Version]  

Introduction

Red Book 2009: 737. [Extract] [Full Version]  



This topic has been referenced by these articles:

  • Lobato, M. N., Jereb, J. A., Starke, J. R. (2008). Unintended Consequences: Mandatory Tuberculin Skin Testing and Severe Isoniazid Hepatotoxicity. Pediatrics 121: e1732-e1733 [Abstract] [Full Version]  
  • Trehan, I., Meinzen-Derr, J. K., Jamison, L., Staat, M. A. (2008). Tuberculosis Screening in Internationally Adopted Children: The Need for Initial and Repeat Testing. Pediatrics 122: e7-e14 [Abstract] [Full Version]  
  • de Steenwinkel, J. E. M., Driessen, G.-J. A., Kamphorst-Roemer, M. H., Zeegers, A. G. M., Ott, A., van Westreenen, M. (2008). Tuberculosis Mimicking Ileocecal Intussusception in a 5-Month-Old Girl. Pediatrics 121: e1434-e1437 [Abstract] [Full Version]  
  • Richeldi, L., Ewer, K., Losi, M., Bergamini, B. M., Millington, K., Fabbri, L. M., Lalvani, A. (2007). T-Cell-Based Diagnosis of Neonatal Multidrug-Resistant Latent Tuberculosis Infection. Pediatrics 119: e1-e5 [Abstract] [Full Version]  
  • Kruk, A., Gie, R. P., Schaaf, H. S., Marais, B. J. (2008). Symptom-Based Screening of Child Tuberculosis Contacts: Improved Feasibility in Resource-Limited Settings. Pediatrics 121: e1646-e1652 [Abstract] [Full Version]  
  • Shaw, J. S., Wasserman, R. C., Barry, S., Delaney, T., Duncan, P., Davis, W., Berry, P. (2006). Statewide Quality Improvement Outreach Improves Preventive Services for Young Children. Pediatrics 118: e1039-e1047 [Abstract] [Full Version]  
  • Mandalakas, A. M., Kirchner, H. L., Iverson, S., Chesney, M., Spencer, M. J., Sidler, A., Johnson, D. (2007). Predictors of Mycobacterium tuberculosis Infection in International Adoptees. Pediatrics 120: e610-e616 [Abstract] [Full Version]  
  • Bergamini, B. M., Losi, M., Vaienti, F., D'Amico, R., Meccugni, B., Meacci, M., De Giovanni, D., Rumpianesi, F., Fabbri, L. M., Balli, F., Richeldi, L. (2009). Performance of Commercial Blood Tests for the Diagnosis of Latent Tuberculosis Infection in Children and Adolescents. Pediatrics 123: e419-e424 [Abstract] [Full Version]  
  • Abdelmoez, B., Abd-El-Nasser, A., Baheeg, M. G., Sedky, A. A. (2008). PREVALENCE OF TUBERCULOSIS AMONG CHILDREN WHO HAD TYPE 1 DIABETES AND WERE ADMITTED TO ELMINIA UNIVERSITY HOSPITAL. Pediatrics 121: S151-S151 [Abstract]  
  • Finnell, S. M. E., Christenson, J. C., Downs, S. M. (2009). Latent Tuberculosis Infection in Children: A Call for Revised Treatment Guidelines. Pediatrics 123: 816-822 [Abstract] [Full Version]  
  • Lighter, J., Rigaud, M., Eduardo, R., Peng, C.-H., Pollack, H. (2009). Latent Tuberculosis Diagnosis in Children by Using the QuantiFERON-TB Gold In-Tube Test. Pediatrics 123: 30-37 [Abstract] [Full Version]  
  • Sterling, T. R., Martire, T., de Almeida, A. S., Ding, L., Greenberg, D. E., Moreira, L. A., Elloumi, H., Torres, A. P.V., Sant'Anna, C. C., Calazans, E., Paraguassu, G., Gebretsadik, T., Shintani, A., Miller, K., Kritski, A., e Silva, J. R. L., Holland, S. M. (2007). Immune Function in Young Children With Previous Pulmonary or Miliary/Meningeal Tuberculosis and Impact of BCG Vaccination. Pediatrics 120: e912-e921 [Abstract] [Full Version]  
  • Jiang, L.-P. (2008). INTERLEUKIN 18 GENE POLYMORPHISM AS A POTENTIAL HOST-SUSCEPTIBILITY FACTOR IN TUBERCULOSIS IN CHONGQING, CHINA. Pediatrics 121: S133-S134 [Abstract]  
  • Brenneman, G., Rhoades, E., Chilton, L. (2006). Forty Years in Partnership: The American Academy of Pediatrics and the Indian Health Service. Pediatrics 118: e1257-e1263 [Abstract] [Full Version]  
  • Flores, A. I., Bilker, W. B., Alessandrini, E. A. (2008). Effects of Continuity of Care in Infancy on Receipt of Lead, Anemia, and Tuberculosis Screening. Pediatrics 121: e399-e406 [Abstract] [Full Version]  
  • Aivazis, V., Vasiliadis, A., Aivazi, D., Zardava, G., Sakellaropoulou, A., Papadimitriou, E., Thanos, V., Roilidis, E. (2008). EVALUATION OF TUBERCULIN SKIN TEST IN UNVACCINATED 0- TO 7-YEAR-OLD CHILDREN OF NORTHERN GREECE. Pediatrics 121: S160-S161 [Abstract]  
  • Lobato, M. N., Jereb, J. A., Castro, K. G. (2009). Do We Have Evidence for Policy Changes in the Treatment of Children With Latent Tuberculosis Infection?. Pediatrics 123: 902-903 [Full Version]  
  • Puiu, I., Stancu, P., Bulucea, D., Niculescu, C., Nicolescu, V. E., Stoian, F. (2008). DIAGNOSIS OF TUBERCULOSIS LYMPHADENITIS IN CHILDREN. Pediatrics 121: S130-S131 [Abstract]  
  • Flaherman, V. J., Porco, T. C., Marseille, E., Royce, S. E. (2007). Cost-effectiveness of Alternative Strategies for Tuberculosis Screening Before Kindergarten Entry. Pediatrics 120: 90-99 [Abstract] [Full Version]  
  • Nicol, M. P., Davies, M.-A., Wood, K., Hatherill, M., Workman, L., Hawkridge, A., Eley, B., Wilkinson, K. A., Wilkinson, R. J., Hanekom, W. A., Beatty, D., Hussey, G. (2009). Comparison of T-SPOT.TB Assay and Tuberculin Skin Test for the Evaluation of Young Children at High Risk for Tuberculosis in a Community Setting. Pediatrics 123: 38-43 [Abstract] [Full Version]  
  • den Boon, S., Verver, S., Marais, B. J., Enarson, D. A., Lombard, C. J., Bateman, E. D., Irusen, E., Jithoo, A., Gie, R. P., Borgdorff, M. W., Beyers, N. (2007). Association Between Passive Smoking and Infection With Mycobacterium tuberculosis in Children. Pediatrics 119: 734-739 [Abstract] [Full Version]  
  • Jiang, L.-P. (2008). ASSOCIATION OF POLYMORPHISMS OF THE INTERLEUKIN 18 RECEPTOR: {alpha} GENE WITH SUSCEPTIBILITY TO TUBERCULOSIS IN CHONGQING, CHINA. Pediatrics 121: S134-S134 [Abstract]  
  • Marais, B. J., Gie, R. P., Hesseling, A. C., Schaaf, H. S., Lombard, C., Enarson, D. A., Beyers, N. (2006). A Refined Symptom-Based Approach to Diagnose Pulmonary Tuberculosis in Children. Pediatrics 118: e1350-e1359 [Abstract] [Full Version]