title: Clinical peculiarities of tuberculosis.
abstract: The ongoing spread of tuberculosis (TB) in poor resource countries and the recently increasing incidence in high resource countries lead to the need of updated knowledge for clinicians, particularly for pediatricians. The purpose of this article is to provide an overview on the most important peculiarities of TB in children. Children are less contagious than adults, but the risk of progression to active disease is higher in infants and children as compared to the subsequent ages. Diagnosis of TB in children is more difficult than in adults, because few signs are associated with primary infection, interferon-gamma release assays and tuberculin skin test are less reliable in younger children, M. tuberculosis is more rarely detected in gastric aspirates than in smears in adults and radiological findings are often not specific. Treatment of latent TB is always necessary in young children, whereas it is recommended in older children, as well as in adults, only in particular conditions. Antimycobacterial drugs are generally better tolerated in children as compared to adults, but off-label use of second-line antimycobacterial drugs is increasing, because of spreading of multidrug resistant TB worldwide. Given that TB is a disease which often involves more than one member in a family, a closer collaboration is needed between pediatricians and clinicians who take care of adults.
authors.forename: Paola
authors.initials: P
authors.lastname: Piccini
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Enrico
authors.initials: E
authors.lastname: Tortoli
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000188:drug therapy; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009928:Organ Specificity; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents