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Pediatric Tuberculosis

Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Anna Starshinova, Viacheslav Zhuravlev, Irina Dovgaluk, Alexandr Panteleev, Vera Manina, Ulia Zinchenko, Evgenia Istomina, Maria Pavlova, Piotr Yablonskiy
Background: The WHO strategy for eradication of tuberculosis (TB) by 2035 (The End TB Strategy) is aimed at an early and precise diagnosis and subsequent effective treatment of TB patients. Currently, there is no gold standard for the diagnosis of latent TB infection. This study evaluated the diagnostic capabilities of a new intradermal test using recombinant TB allergen (Diaskintest) compared with tuberculin skin test (TST) and commercial TB interferon-gamma release assays (IGRAs). Methods: A post-hoc data analysis that involved examining 860 HIV-negative, bacillus Calmette-Guérin (BCG)-vaccinated persons aged 1-65 years who visited the TB health-care institutions of Saint Petersburg to rule out or confirm an active TB was conducted from 2011 to 2016...
January 2018: International Journal of Mycobacteriology
Lisa Frigati, Moherdran Archary, Helena Rabie, Martina Penazzato, Nathan Ford
Early mortality and morbidity remain high in children initiating antiretroviral therapy (ART), especially in sub-Saharan Africa. Many children still present with advanced human immunodeficiency virus (HIV) disease. Tuberculosis, pneumonia, and severe bacterial infections are the main causes of hospital admission in HIV-infected children. In contrast to adults with advanced HIV disease, cryptococcal disease is not common in childhood, although there is a peak in infancy and adolescence. Interventions such as TB screening in symptomatic children, and isoniazid and cotrimoxazole prophylaxis should be implemented...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Karoline van de Loo, Stefan Balzer, Colin R MacKenzie, Thomas M Boemers, Monika Ortmann, Jörg Schaper, Arndt Borkhardt, Hans-Jürgen Laws, Michaela Kuhlen
BACKGROUND: Mycobacterium tuberculosis (M. tuberculosis) disease is a generally well-known problem among immunocompromised adults and children. In pediatric oncology, only few cases of M. tuberculosis disease are reported so far. CASE PRESENTATION: We report a case of concomitant lymphnode tuberculosis in a 4-year-old German boy with relapsed ganglioneuroblastoma. 18 months after the initial diagnosis, relapse with new paravertebral lesions and new lesions in the left lower lobe of the lung and in the perihilar lymphnodes suspicious of metastases of the ganglioneuroblastoma were detected...
March 5, 2018: BMC Infectious Diseases
Fabian Speth, Claas H Hinze, Susanne Andel, Thomas Mertens, Johannes-Peter Haas
BACKGROUND: The goal of this study was to apply the varicella zoster virus (VZV) vaccine to patients with pediatric rheumatic diseases (PRD) at risk for severe chickenpox, without interrupting their current immunosuppression, including biological agents, using an immunological-based pre-vaccination checklist to assure safety. A pre-vaccination checklist was implemented to ensure adequate immune competence prior to immunization. METHODS: This prospective study included seronegative patients (VZV-IgG ≤200 mIU/ml) and patients who had previously received only a single dose of VZV vaccine...
March 2, 2018: Pediatric Rheumatology Online Journal
Tinsae Alemayehu, Wondwossen Ergete, Workeabeba Abebe
Background: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs. Conclusion: Tuberculosis should be considered in children with a chronic headache or focal neurologic deficit and a supra-tentorial intracranial mass in endemic countries like Ethiopia...
November 2017: Ethiopian Journal of Health Sciences
Lucie Cluver, Marija Pantelic, Mark Orkin, Elona Toska, Sally Medley, Lorraine Sherr
INTRODUCTION: The Sustainable Development Goals (SDGs) present a groundbreaking global development agenda to protect the most vulnerable. Adolescents living with HIV in Sub-Saharan Africa continue to experience extreme health vulnerabilities, but we know little about the impacts of SDG-aligned provisions on their health. This study tests associations of provisions aligned with five SDGs with potential mortality risks. METHODS: Clinical and interview data were gathered from N = 1060 adolescents living with HIV in rural and urban South Africa in 2014 to 2015...
February 2018: Journal of the International AIDS Society
Amanda Willig, Lauri Wright, Theresa A Galvin
Nutrition is an integral component of medical care for people living with human immunodeficiency virus (HIV)/autoimmune deficiency syndrome (AIDS) (PLWHA). The Academy of Nutrition and Dietetics supports integration of medical nutrition therapy into routine care for this population. Fewer PLWHA experience wasting and undernutrition, while the prevalence of obesity and other chronic diseases has increased significantly. Improved understanding of HIV infection's impact on metabolism and chronic inflammation has only increased the complexity of managing chronic HIV infection...
March 2018: Journal of the Academy of Nutrition and Dietetics
Betsy Rebecca, Anila Chacko, Valsan Verghese, Winsley Rose
Background: Pediatric tuberculosis (TB) is often underdiagnosed with poor estimate of its true burden. Availability of Xpert MTB/RIF assay enhances diagnostic capacity of pediatric TB. Methods: A 3-year retrospective review of hospital records was done for all children diagnosed with confirmed and unconfirmed TB. Comparison was made between intrathoracic, single-site extrathoracic and disseminated TB. Results: In total, 274 children had TB with 130 (47...
February 13, 2018: Journal of Tropical Pediatrics
Bishnu Rath Giri, Ram Hari Chapagain, Samana Sharma, Sandeep Shrestha, Sunita Ghimire, P Ravi Shankar
BACKGROUND: Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. METHODS: We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7...
February 5, 2018: BMC Pediatrics
Teera Kijmassuwan, Pornthep Tanpowpong, Sani Molagool, Suporn Treepongkaruna
Enteritis and small bowel ulcers can be caused by inflammatory bowel disease, drug-induced enteritis, cytomegalovirus, tuberculosis, or intestinal lymphoma. Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is an uncommon idiopathic cause of ulceration and stricture of the small bowel. CMUSE can occur in adults, but only few pediatric cases have been reported. Inflammatory bowel disease and other causes should be carefully sought first before the diagnosis of CMUSE can be made. Previous reports demonstrated that surgical intervention may be necessary for both diagnostic and therapeutic purposes...
January 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Shirin Sayyahfar, Faranak Davoodzadeh, Rozita Hoseini, Nahid Rahimzadeh, Hasan Otukesh
IGRA has been approved as an alternative in vitro test to diagnose Mycobacterium TB infection. This study aimed to assess the diagnostic value of TST in comparison with QFT assay to detect LTBI among Iranian children candidate for renal transplantation. This cross-sectional study was performed on 31 children who were candidate for renal transplantation admitted to Ali Asghar Children's Hospital and Rasoul Akram Hospital, Tehran, Iran, from 2013 to 2014. TST and QFT were performed for all patients. QFT was negative in all patients, while TST was positive only in one case...
March 2018: Pediatric Transplantation
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
Eneritz Velasco-Arnaiz, Esther Pérez, Desirée Henares, Anna Fernández-López, Anna Valls, Pedro Brotons, Clàudia Fortuny, Antoni Noguera-Julian
Normal procalcitonin (PCT) levels have been reported in adult pulmonary tuberculosis (TB) but have not been previously investigated in children. We aimed to assess PCT levels at diagnosis of TB in young children in a low-burden setting. In a cross-sectional observational study in a referral pediatric center in Barcelona (Spain), we assessed the value of PCT and other inflammatory markers (leucocyte counts, C-reactive protein, and erythrocyte sedimentation rate) in the diagnosis of TB in pre-school children (< 6 years at diagnosis, n = 45), as compared with two control groups (pneumococcal pneumonia, n = 25; and healthy controls, n = 49)...
January 27, 2018: European Journal of Pediatrics
Christelle Géneviève Jouego, Valirie Ndip Agbor, Juergen Noeske, Ndo Akono Manuel, Leo Njock Ayuk
BACKGROUND: Tuberculosis remains a major cause of morbidity and mortality worldwide, especially in developing countries. The diagnosis and treatment of multi-drug resistant tuberculosis (MDR-TB) in children remain a major limitation in this setting, largely due to difficulties in isolating Mycobacterium tuberculosis from pediatric specimens, management with toxic second line drugs, and practically the inexistence of contact tracing. In 2016, the World Health Organization (WHO) recommended a standardized 9-month regimen for adults and children in zones which are highly endemic for the human immunodeficiency virus (HIV)...
January 22, 2018: BMC Research Notes
Samuel Rosas, Daniel Rosas, Valentina Múnera Orozco, Manuela Parra Cardona, Chukwuweike Gwam, Simon Pedro Aristizabal
Pediatric septic arthritis can be a devastating disease. Often, the diagnosis can be challenging as autoimmune and infectious causes may present in a similar fashion. Thus, we present the case of a five-year-old male patient, from the Pacific coast of Colombia, with chronic morning knee pain and stiffness thought to be caused by an autoimmune disease. He presented with a mild effusion of the left knee, a flexed posture, and limited extension to 25°. Inflammatory markers demonstrated an infectious pattern. Autoimmune markers were negative...
December 22, 2017: Surgical Technology International
Brian C Zanoni, Thobekile Sibaya, Chelline Cairns, Sara Lammert, Jessica E Haberer
OBJECTIVE: To determine retention in care and virologic suppression among HIV-infected adolescents and young adults attending an adolescent-friendly clinic compared to those attending the standard pediatric clinic at the same site. DESIGN: Retrospective cohort analysis. SETTING: Government supported, hospital-based antiretroviral clinic in KwaZulu-Natal, South Africa. PARTICIPANTS: Two hundred forty-one perinatally HIV-infected adolescents and young adults aged 13 to 24 years attending an adolescent-friendly clinic or the standard pediatric clinic from April 2007 to November 2015...
2017: PloS One
Gokhan Cavus, Yurdal Gezercan, Ali Ihsan Ökten, Orkun Tolunay, Tamer Çelik, Ali Arslan, Ümit Çelik
PURPOSE: Tuberculosis is a common disease worldwide that is caused by Mycobacterium tuberculosis. Tuberculosis is primarily a pulmonary disease, but extrapulmonary manifestations are not uncommon, especially in children and adolescents. METHODS: We present two pediatric patients who underwent surgery in our clinic for Pott's disease in the upper thoracic region. The patients were investigated to describe their age, complaints, neurological examination results, disease location, surgical procedure, and complications...
December 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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