Tuberculosis in children

Children are found mainly primary forms of tuberculosis, which often manifest themselves defeat a number of organs and systems with a violation of their functions.
The initial period of infection is characterized by the formation of a primary complex, often in a lightweight, defeat bronchial nodes (see Bronchogenic), and other lymph nodes, often exposed cheesy rebirth. In this period there is a high sensitization of tissues and organs to Mycobacterium tuberculosis. This manifests the high tuberculin sensitivity and parspecifically reactions (likteni, scrofulous, erythema nodosum).
Form of tuberculosis, the course and outcome of the disease depend on the child's age and body resistance. In infants and young children tuberculosis severe than children of older age. Often acutely progressive forms of primary TB (miliary TB, meningitis). The tendency in this age to the adverse period due to the failure of adaptive and protective mechanisms. In children of preschool and school age dominated by forms without clear localization and is in a more favorable course of tuberculosis. In children of school age and teenagers are found mainly secondary forms of tuberculosis. At this age a negative impact on the course of tuberculosis has modify the reactivity of the organism, caused by endocrine restructuring of puberty.
Due to improvement of social and living conditions, the success of treatment bacteriostatic drugs and widespread use of preventive vaccination and revaccination with BCG has changed course and outcome of tuberculosis in children. Currently, there is more favourable for primary forms, reduced the number of severe complications.
Early tuberculous intoxication. From the time of infection until a positive tuberculin skin test, and expressed pathomorphological changes goes on average from 4 to 10 weeks. This period in most cases is accompanied by functional disorders characteristic of tuberculosis intoxication (early tuberculous intoxication) and is caused by bacillemia.
Symptoms of intoxication are increasing as a result of a positive tuberculin skin test. Marked deterioration of the General condition, sometimes subfebrile temperature, decrease in appetite, poor sleep, lack of increase of weight, fatigue, irritability, or lethargy. In infants often there are gastrointestinal disorders, non-infringement of feeding. Peripheral lymph nodes (mainly the armpit or neck) constantly increased, doughy consistency, sometimes with the phenomena of peradenia. In some cases, functional disorders are blurred expressed and short-term, others gradually develop chronic tuberculous intoxication or local forms of tuberculosis.
Chronic tuberculosis intoxication. The term proposed by A. A. Kissel (1918) to refer to those forms of tuberculosis in which the body's response to tuberculosis is expressed only General disorders and the minimum morphological changes cannot be detected by the available methods.
In the basis of chronic tuberculosis intoxication is the lymph system (a bronchial, mesenteric and peripheral lymph nodes) in various phases of development.
Chronic tuberculous intoxication usually develops in the later period of primary TB infection, often in the period of active, but hidden flowing process. It may be the outcome of untreated early tuberculosis intoxication, and also can develop in the period of remission local process.
Most of the symptoms of chronic tuberculosis intoxication are not specific, are observed with other chronic diseases (diseases of the tonsils, sinuses, pyelonephritis, cholecystitis, rheumatic fever, brucellosis and other).
Chronic tuberculous intoxication occurs in children often and runs favorably.
In the diagnosis of chronic tuberculosis intoxication have a value indicating the contact with TB patients, positive tuberculin skin test, especially characteristic changes of peripheral lymph nodes.