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Pediatric Tuberculosis

Swapnali Sabhapandit, Somasheila I Murthy, Vivek M Singh, Ketaki Gaitonde, Madhumita Gopal, Kerul Marsonia, Shajeera Sajid, Kalpana Babu
PURPOSE: To report the epidemiology of uveitis in two urban centers in South India. METHODS: Case records seen between January 2014 and December 2014 at two tertiary eye centers in South India were retrospectively reviewed. RESULTS: A total of 1123 patients in the study population had uveitis. Anterior uveitis was seen in 48.9%, posterior in 20.5%, intermediate in 17.3%, and panuveitis in 13.3%. Of these cases, 68.4% were acute uveitis. Pediatric uveitis constituted 6...
October 26, 2016: Ocular Immunology and Inflammation
Natasha Gautam, Ramandeep Singh, Aniruddha Agarwal, Sonam Yangzes, Mohit Dogra, Ashok Sharma, Reema Bansal, Vishali Gupta, Mangat R Dogra, Amod Gupta
PURPOSE: To report the pattern of pediatric uveitis in a tertiary care referral center in North India. METHODS: In a retrospective study, records of pediatric uveitis cases presenting at our center between 1996 and 2015 were reviewed for demographic data, anatomic distribution, and diagnosis. RESULTS: Out of 9600 patients with uveitis, 369 children (3.84%; age ≤16 years; males: 54.20%) were included in the study. Anterior uveitis was the commonest presentation (n = 158; 42...
October 21, 2016: Ocular Immunology and Inflammation
Begoña Santiago-García, Daniel Blázquez-Gamero, Fernando Baquero-Artigao, Jesús Ruíz-Contreras, Jose M Bellón, Maria A Muñoz-Fernández, María J Mellado-Peña
BACKGROUND: Children are at higher risk of tuberculosis (TB) dissemination and extrapulmonary disease, contributing greatly to TB-associated morbidity and long-term sequelae. However, there are very few studies that assess the impact and clinical spectrum of pediatric extrapulmonary TB (EPTB) in low-prevalence regions. METHODS: Children <18 years of age diagnosed with TB in Madrid region (2005-2013) were reviewed. We compared the epidemiology, clinical characteristics and the performance of diagnostic tests in childhood extrapulmonary and pulmonary disease...
November 2016: Pediatric Infectious Disease Journal
Carmelo Guerrero-Laleona, Joan Calzada-Hernández, Matilde Bustillo-Alonso, Jorge Gil-Albarova, Marta Medrano-San Ildefonso, Estibaliz Iglesias-Jiménez, Antoni Noguera-Julian
Treatment with tumor necrosis factor-α inhibitors is a risk factor for tuberculosis. Despite previous treatment with isoniazid for latent tuberculosis, a 9-year-old girl with juvenile idiopathic arthritis developed disseminated tuberculosis after changing therapy with etanercept to adalimumab and after new contact with a smear-positive relative. Genotyping strain matches and susceptibility to isoniazid make reinfection more likely than reactivation in our patient.
October 3, 2016: Pediatric Infectious Disease Journal
Roberta Petrucci, Giulia Lombardi, Ilaria Corsini, Maria Letizia Bacchi Reggiani, Francesca Visciotti, Filippo Bernardi, Maria Paola Landini, Salvatore Cazzato, Paola Dal Monte
BACKGROUND: The diagnostic accuracy of Quantiferon-TB Gold In-Tube (QFT-IT) is uncertain in the pediatric population, while tuberculin skin test (TST) is still conventionally used despite its limitations. The aim of this study was to compare the performance of QFT-IT with TST in a large cohort of children screened for TB infection because of contact tracing, suspected TB, arrival from endemic country or immunosuppressive therapy. METHODS: A retrospective analysis was conducted on 517 children 0-14 years of age evaluated at the pediatric unit of the S...
October 3, 2016: Pediatric Infectious Disease Journal
Tawanda Gumbo, Mamodikoe K Makhene, James A Seddon
There has been a recent expansion of preclinical models to predict the efficacy of regimens to treat adults with tuberculosis. Despite increasing global interest in childhood tuberculosis, these same tools have not been employed to develop pediatric regimens. Children differ from adults in bacillary burden, spectrum of disease, the metabolism and distribution of antituberculosis drugs, and the toxicity experienced. The studies documented in this series describe a proof-of-concept approach to pediatric regimen development...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Devyani Deshpande, Shashikant Srivastava, Eric Nuermberger, Jotam G Pasipanodya, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  The regimen of linezolid and moxifloxacin was found to be efficacious in the hollow fiber system model of pediatric intracellular tuberculosis. However, its kill rate was slower than the standard 3-drug regimen of isoniazid, rifampin, and pyrazinamide. We wanted to examine the effect of adding a third oral agent, faropenem, to this dual combination. METHODS:  We performed a series of studies in the hollow fiber system model of intracellular Mycobacterium tuberculosis, by mimicking pediatric pharmacokinetics of each antibiotic...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Devyani Deshpande, Shashikant Srivastava, Eric Nuermberger, Jotam G Pasipanodya, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  No treatment regimens have been specifically designed for children, in whom tuberculosis is predominantly intracellular. Given their activity as monotherapy and their ability to penetrate many diseased anatomic sites that characterize disseminated tuberculosis, linezolid and moxifloxacin could be combined to form a regimen for this need. METHODS:  We examined microbial kill of intracellular Mycobacterium tuberculosis (Mtb) by the combination of linezolid and moxifloxacin multiple exposures in a 7-by-7 mathematical matrix...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Stephen J Bush, Eric Nuermberger, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  Infants and toddlers often present with disseminated and lymph node tuberculosis, in which Mycobacterium tuberculosis (Mtb) is predominantly intracellular. Linezolid, used to treat tuberculosis in adults, has not been formally studied in infants. Infants clear linezolid 5 times faster than adults and achieve lower 0- to 24-hour area under the concentration-time curves (AUC0-24). METHODS:  To mimic intracellular disease, we infected human-derived THP-1 macrophages with Mtb and inoculated hollow fiber systems...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Shashikant Srivastava, Devyani Deshpande, Jotam G Pasipanodya, Tania Thomas, Soumya Swaminathan, Eric Nuermberger, Tawanda Gumbo
Children with tuberculosis are treated with drug regimens copied from adults despite significant differences in antibiotic pharmacokinetics, pathology, and the microbial burden between childhood and adult tuberculosis. We sought to develop a new and effective oral treatment regimen specific to children of different ages. We investigated and validated the concept that target drug concentrations associated with therapy failure and death in children are different from those of adults. On that basis, we proposed a 4-step program to rapidly develop treatment regimens for children...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Preeti Sule, Ronak Tilvawala, Parnia Behinaein, Grant K Walkup, Jeffrey D Cirillo
Although tuberculosis (TB) is one of the most common causes of morbidity and mortality in humans worldwide and diagnostic methods have been in place for more than 100 years, diagnosis remains a challenge. The main problems with diagnosis relate to the time needed to obtain a definitive result, difficulty in obtaining sputum, the primary clinical material used, and the ability of the causative agent, Mycobacterium tuberculosis, to cause disease in nearly any tissue within the body. In order to decrease incidence of TB, discovery of a novel interventions will be required, since current technologies have only been able to control numbers of infections, not reduce them...
September 28, 2016: Tuberculosis
Andrew R DiNardo, Anne Detjen, Pilar Ustero, Katherine Ngo, Jason Bacha, Anna M Mandalakas
No abstract text is available yet for this article.
September 28, 2016: Tuberculosis
Houda Snène, Anissa Berraies, Besma Hamdi, Jamel Ammar, Hanadi Ouali, Agnes Hamzaoui
Objective to assess the different localizations of tuberculosis (TB) in children in a pneumopediatric department in Tunisia and to describe its diagnosis tools since clinical investigations of childhood TB are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. Methods Forty-six cases of TB in children were studied between 2008 and 2013. Clinical history, examination and chest radiography were reported. Several investigations have been conducted to confirm the diagnosis of TB such as: tuberculin skin test (TST), bacteriological and histological investigations...
April 2016: La Tunisie Médicale
Elizabeth Park, Tiny Masupe, Joseph Joseph, Ari Ho-Foster, Afton Chavez, Swetha Jammalamadugu, Andrew Marek, Ruth Arumala, Dineo Ketshogileng, Ryan Littman-Quinn, Carrie Kovarik
BACKGROUND: Since the UN Human Rights Council's recognition on the subject in 2011, the right to access the Internet and information is now considered one of the most basic human rights of global citizens [1,2]. Despite this, an information gap between developed and resource-limited countries remains, and there is scant research on actual information needs of workers themselves. The Republic of Botswana represents a fertile ground to address existing gaps in research, policy, and practice, due to its demonstrated gap in access to information and specialists among rural health care workers (HCWs), burgeoning mHealth capacity, and a timely offer from Orange Telecommunications to access Wikipedia for free on mobile platforms for Botswana subscribers...
November 2016: International Journal of Medical Informatics
Esin Aktas Cetin, Leyla Pur Ozyigit, Yusuf Metin Gelmez, Erkan Cakir, Ahmet Hakan Gedik, Gunnur Deniz
OBJECTIVES: Childhood tuberculosis (TB) comprises an important part of the world's TB burden. Monocytes set up the early phase of infection because of innate immune responses. Understanding the changes in monocyte subsets during multisystem infectious diseases may be important for the development of novel diagnostic and therapeutic strategies. The aim of this study was to evaluate the monocyte phenotype together with the cytokine secretion profiles of children with pulmonary tuberculosis...
September 29, 2016: Pediatric Pulmonology
Ozgul Yigit, Meltem Erol, Ozlem Bostan Gayret, Isıl Ustun, Selami Ulas
INTRODUCTION: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott's disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy...
July 2016: Iranian Red Crescent Medical Journal
Lemi Mosissa, Abebaw Kebede, Tedla Mindaye, Muluwork Getahun, Sisay Tulu, Kassu Desta
Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes...
2016: Pan African Medical Journal
Yeongsang Jeong, Yong Hyun Bang, Yun-Kyung Kim
Migrating pulmonary lesions in children are uncommon, and most are caused by eosinophilic lung disease and parasite, fungus, and tuberculosis infections. A 12-year-old boy was referred to our hospital because of an abnormal chest x-ray. Serial computed tomography scans performed over several months showed a migrating pulmonary consolidation in the left lung, although the patient remained asymptomatic. Finally, surgical biopsy was performed and follicular bronchiolitis was diagnosed. The consolidation disappeared 17 months later without treatment, and the patient has remained asymptomatic...
September 18, 2016: Pediatric Pulmonology
Payam Nahid, Susan E Dorman, Narges Alipanah, Pennan M Barry, Jan L Brozek, Adithya Cattamanchi, Lelia H Chaisson, Richard E Chaisson, Charles L Daley, Malgosia Grzemska, Julie M Higashi, Christine S Ho, Philip C Hopewell, Salmaan A Keshavjee, Christian Lienhardt, Richard Menzies, Cynthia Merrifield, Masahiro Narita, Rick O'Brien, Charles A Peloquin, Ann Raftery, Jussi Saukkonen, H Simon Schaaf, Giovanni Sotgiu, Jeffrey R Starke, Giovanni Battista Migliori, Andrew Vernon
The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline...
October 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sudha K Ganesh, Saurabh Mistry
PURPOSE: To analyze the outcome of phacoemulsification with primary posterior chamber intraocular lens (IOL) implantation without primary posterior capsulorhexis in older children with uveitis. METHODS: Retrospective study of children with uveitis who underwent phacoemulsification with IOL implantation between January 2006 and May 2014. RESULTS: Twenty-one eyes of 16 children were included. Mean age at cataract surgery was 10.9 years. Juvenile idiopathic arthritis was associated in 37...
September 6, 2016: Ocular Immunology and Inflammation
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