Skip Navigation LinksHome > September 2013 - Volume 32 - Issue 9 > Adolescents With Tuberculosis: A Review of 145 Cases
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3182933214
Original Studies

Adolescents With Tuberculosis: A Review of 145 Cases

Cruz, Andrea T. MD, MPH; Hwang, Kevin M. BA; Birnbaum, Gilad D. BA; Starke, Jeffrey R. MD

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Background: Adolescents comprise one-third of pediatric tuberculosis (TB) cases in the United States, but there are few specific data on the epidemiology and clinical course in this population.

Methods: This was a retrospective review of adolescents (12–18 years old) seen at a Children’s Tuberculosis Clinic in Houston, TX, from 1987 to 2012.

Results: One hundred forty-five adolescents were identified; median age was 15.4 years: 50% female, 55% were Hispanic, 26% black, 13% Asian and 1% white; 54 were born abroad. Diagnoses were made after symptomatic presentation in 79%, during contact investigations in 14% and after screening tuberculin skin testing in the remainder. The most common symptoms were fever (63%), cough (60%) and weight loss (30%), but 21% were asymptomatic at diagnosis. Only 8% of adolescents with intrathoracic TB had hemoptysis. One hundred fourteen (78.6%) had isolated intrathoracic TB, 4 (2.8%) had intra- and extrathoracic TB and 27 (18.6%) had extrathoracic TB. The most common sites of extrathoracic TB were peripheral lymphadenopathy (10) and meningitis (6). The most common radiographic findings were infiltrates (34%), lymphadenopathy (27%), cavitary lesions (26%), pleural effusions (19%) and miliary disease (10%). Acid-fast bacillus smears and mycobacterial cultures were attempted for 97 of 118 adolescents with intrathoracic and 22 of 27 with extrathoracic disease, respectively, resulting in smear/culture positivity in 25% and 54% and 18% and 45%, respectively. Two patients died, 2 had relapse, 7 had significant sequelae and 92% recovered without complication. Seventy three percent of cases potentially were preventable.

Conclusions: The clinical, radiologic and microbiologic findings in adolescents with TB have features seen in both younger children and adults; most cases were preventable.

© 2013 by Lippincott Williams & Wilkins, Inc.


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