Pulmonary Tuberculosis In Children

Tuberculosis was the major cause of death in Europe and North America in the 18th and 19th centuries. This chapter deals with pulmonary tuberculosis in children — its pathogenesis, clinical manifestations, diagnosis, management, and prognosis. The tuberculin test is the basic diagnostic tool for finding tuberculous infection, both in contacts of patients with active disease and in establishing tuberculosis as the etiology of an illness in a sick child. Generalized pleurisy with effusion is a response in the tuberculin-sensitive host to the rupture of a small subpleural caseous focus into the pleural space. The risk of developing chronic pulmonary tuberculosis in untreated children is much greater for the child whose tuberculin conversion occurred after age 7; adolescents are at risk of developing it within 1 to 2 years. The diagnosis of tuberculosis in children is assumed in the presence of a positive tuberculin skin test and a chest roentgenogram or clinical findings compatable with the disease.