title: A profile of bacteriologically confirmed pulmonary tuberculosis in children.
abstract: OBJECTIVE
  To describe the clinical profile of children with bacteriologically confirmed tuberculosis.
  
  
  METHODS
  A multicentric study was conducted in three hospitals in Chennai city between July 1995 and December 1997. Children aged 6 months to 12 years with signs and symptoms suggestive of tuberculosis were investigated further. Clinical examination, chest radiograph, tuberculin skin test with 1 TU PPD and, sputum or gastric lavage for mycobacterial smear and culture were done for all and, lymph node biopsy when necessary.
  
  
  RESULTS
  A total of 2652 children were registered and tuberculosis was bacteriologically confirmed in 201. Predominant symptoms were history of an insidious illness (49%), fever and cough (47%), loss of weight (41%) and a visible glandular swelling (49%). Respiratory signs were few and 62% were undernourished. Over half the patients with confirmed TB had normal chest X-ray. Abnormal X-ray findings included parenchymal opacities in 47% and hilar or mediastinal lymphadenopathy in 26%. The prevalence of isoniazid resistance was 12.6% and MDR TB 4%.
  
  
  CONCLUSIONS
  Children with tuberculosis present with fever and cough of insidious onset. Lymphadenopathy is a common feature even in children with pulmonary TB. A significant proportion of children have normal chest X-rays despite positive gastric aspirate cultures. Drug resistance rates in children mirror the pattern seen in adults in this geographic area.
authors.affiliation: Division of HIV/AIDS, Tuberculosis Research Centre, Chetput, Chennai, India. doctorsoumya@yahoo.com
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
authors.forename: Manjula
authors.initials: M
authors.lastname: Datta
authors.forename: M P
authors.initials: MP
authors.lastname: Radhamani
authors.forename: Sara
authors.initials: S
authors.lastname: Mathew
authors.forename: A M
authors.initials: AM
authors.lastname: Reetha
authors.forename: Sarala
authors.initials: S
authors.lastname: Rajajee
authors.forename: Rema
authors.initials: R
authors.lastname: Mathew
authors.forename: A
authors.initials: A
authors.lastname: Radhakrishnan
authors.forename: M B
authors.initials: MB
authors.lastname: Raghu
mesh_terms: D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology