التفاصيل البيبلوغرافية
| العنوان: |
Difficulties in diagnosis of tuberculosis without bacteriological confirmation in a 15-year-old boy after the contact with a patient with tuberculosis -- A case report. |
| العنوان البديل: |
Teškoće u dijagnostici tuberkuloze bez bakteriološke potvrde kod 15-godišnjeg bolesnika dobijene kontaktom sa obolelim od tuberkuloze. |
| المؤلفون: |
Kostić, Gordana1,2 gocakostic58@gmail.com, Medović, Raša1,2, Marković, Slavica1,2, Rašković, Zorica1,2, Igrutinović, Zoran1,2, Ćupurdija, Vojislav2,3, Petrović, Marina2,3 |
| المصدر: |
Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia. May2018, Vol. 75 Issue 5, p516-520. 5p. |
| مصطلحات موضوعية: |
*DYSPNEA, *TUBERCULIN test, *MYCOBACTERIUM tuberculosis, TUBERCULOSIS case studies, DIAGNOSIS of tuberculosis in children |
| الملخص (بالإنجليزية): |
Introduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%-16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%-25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with productive cough, pain in the right flank area, fever, and fatigue, loss of appetite and night sweats. One of the boy's uncles was cured of tuberculosis, another uncle had active tuberculosis and both of them were in contact with the boy, but they did not live in the same household. During the physical examination, the child was febrile, with dyspnea, pale, with profuse sweating, debilitate. BCG (Bacillus Calmette -- Guérin) scar was present. The auscultatory findings of the lungs showed quiet breathing from the scapula to the right lung base and chest radiography suggested massive right sided pleuropneumonia. The parameters of the inflammation were high and Mycobacterium tuberculosis (MTB) was not found in the samples of sputum and gastric lavage. Pleural puncture revealed exudative nature in the aspirated fragment. Cytology was nonspecific, the MTB was not found and the planted surfaces on Lowenstein-Jensen remained sterile. Tuberculin skin test (TST) -- Mantoux was positive (+ 10 mm), Interferon Gamma Release Assay (QuantiFERON-TB GOLD In-Tube) was negative. The boy was unsuccessfully treated with broad spectrum antibiotics. By video-assisted thoracoscopy, the pleural tissue clip confirmed the benign chronic granulomatous process, while histochemical staining did not show MTB. The treatment with anti-TB medication led to clinical and radiographic recovery. The boy is now in good general condition, without consequences of the disease. Conclusion. This case report pointed out the importance of risk factors and difficulties in diagnosing TB in children. [ABSTRACT FROM AUTHOR] |
| Abstract (Bosnian): |
Uvod. Nakon kontakta prethodno zdrave dece sa obolelim od tuberkuloze (TB) mogućnost razvoja bolesti iznosi 1%-16%. Dijagnozu TB kod dece nije lako potvrditi tako da 15%-25% slučajeva ostaje nedijagnostikovano. Prikaz slučaja. Dečak star 15 godina hospitalizovan je zbog produktivnog kašlja, bola u desnom slabinskom predelu, povišene temperature, malaksalosti, gubitka apetita i noćnog znojenja. Jedan dečakov ujak izlečen je od tuberkuloze, drugi ujak ima aktivnu tuberkulozu, obojica su bila u kontaktu sa dečakom, ali ne žive u istom domaćinstvu. Pri fizikalnom pregledu bolesnik je bio febrilan, dispnoičan, bled, sa profuznim znojenjem, adinamičan. BCG (Bacillus Calmette -- Guérin) ožiljak je prisutan. Radiografija grudnog koša ukazivala je na masivnu desnostranu pleuropneumoniju. Parametri inflamacije su bili povišeni, a u uzorcima sputuma i gastričnog lavata nije nađen Mycobacterium tuberculosis (MTB). Pleuralnom punkcijom, utvrđeno je da je punktat eksudativne prirode. Citološki pregled bio je nespecifičan, nisu nađeni MTB i sve zasejane podloge na kulturi Lowenstein-Jensen ostale su sterilne. Tuberkulinski kožni test Mantoux bio je pozitivan (+10 mm). Interferon Gamma Release Assay (QuantiFERON- TB GOLD in-Tube) bio je negativan. Dečak je bez uspeha lečen antibioticima širokog spektra dejstva. Video-- asistiranom torakoskopijom, isečak tkiva pleure potvrdio je da se radi o benignom, hroničnom granulomatoznom procesu, dok histohemijskim bojenjem nisu viđeni MTB. Započeto lečenje antituberkuloticima dovelo je do kliničkog oporavka i radiografske regresije. Dečak je sada dobrog opšteg stanja, bez sekvela bolesti. Zaključak. Ovaj prikaz slučaja ukazao je na značaj faktora rizika, kao i otežano dijagnostikovanje TB kod dece. Auskultacijom pluća ustanovljeno je nečujno disanje od skapule desno ka bazi pluća. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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