8.2 TB In Children Flashcards
TB is propagated how?
Social factors, poverty, crowding, disease, Airborne
TB in lungs form?
Caseating granulomas
Children spreaders of TB?
Rarely, they are ‘spill over’ host.
Adolescents spread easily
Main: ‘home’ of TB in lung?
Lung Macrophage, then lymph nodes, present to T-cell
Back to lung
Granuloma
When is the worst time in your life to inhale TB?
Infant
Also get severe forms, meningitis, military
Adolescents are infectious with which form of TB?
Pulmonary, can get own cavities and spread it
Pulmonary TB has what classic thing?
Ghon focus (transient lesion)
Which lung lymph nodes are most affected in child TB?
Sub-carinal nodes
See an x-ray that looks like bad pneumonia, how to tell if bacteria v. TB?
TB - walks into your office, not unwell, not in ICU.
Bacterial: very unwell
What does TB do to the airway?
Compresses the airway on CXR
When does adult-type disease develop in kids?
Past around age of 10
What is the most common manifestation of extra-pulmonary tB?
Cervical lymphadenitis
- persistent mass
- no local cause
- no response to Abx
3 common TB diagnosis?
- Zeil-Neison
- immunofluorescence
- culture
TB skin test tests what?
- Exposure, not active disease.
- not sensitive, not a rule out test
What is the mantoux method?
Measure transverse diameter of the swelling with pen
>10mm: non-HIV infected
>5mm: HIVinfected
TST and T-cell assays for TB tell us what?
About infection
NOT about disease
What symptoms in children with suspected TB?
> 2weeks cough
-failure to thrive >3/12
-fatigue lethargy
PERSISTENT symptoms
TB lymph node, how to sample it?
Fine needle aspirate
Excision also biopsy (not incisional)
New TB test in children?
Xpert MTB/RIF
More sensitive than smear, not as much as culture
Gives answer in 2 hours
How to dx TB meningitis?
LP Raised ICP High protein Less cells Lymphocytes
Rx of TB in children
2/12 intensive (ING,Rif,PZA)
4/12 continuation (INH, Rif)
BCG prevents against?
Miliary and disseminated TB
Why important to treat children with HIV?
Treat early so you can give BCG vaccine
ART for pregnant mothers too
