Tuberculosis in children

The term “tuber­cu­lo­sis” is of Latin ori­gin and means “tuber­cle”. This name is due to the fact that tuber­cu­lo­sis of the skin often man­i­fests itself in the form of a kind of pro­tru­sion on the skin — a tuber­cle. The causative agent of the dis­ease is a tuber­cle bacil­lus or Koch’s bacil­lus — an extreme­ly sta­ble microbe in the exter­nal envi­ron­ment. The bac­teri­um remains active for a long time in dried spu­tum, soil and is not sus­cep­ti­ble to many dis­in­fec­tants. The main mech­a­nism of infec­tion with a tuber­cle bacil­lus is through the air. You can also become infect­ed through the use of prod­ucts con­tain­ing the pathogen, as well as through con­tact with objects on which the microbe is locat­ed.

Tuber­cu­lo­sis and its forms

Tuber­cu­lo­sis is an infec­tious dis­ease caused by Koch’s bacil­lus. Var­i­ous organs and tis­sues of the body can be infect­ed: eyes, skin, intestines, gen­i­touri­nary sys­tem, etc. Pul­monary tuber­cu­lo­sis is the most com­mon.

The course of the dis­ease in chil­dren has a num­ber of fea­tures. Pul­monary tuber­cu­lo­sis in chil­dren is more severe than in adults and can pro­voke many com­pli­ca­tions. This is due to the fact that the immune sys­tem of babies is not yet formed and can­not imme­di­ate­ly lim­it the focus of infec­tion.

In chil­dren under two years of age, a wide spread of the dis­ease is pos­si­ble: tuber­cu­lous menin­gi­tis, mil­iary tuber­cu­lo­sis, tuber­cu­lous sep­sis, etc. In old­er chil­dren, the immune sys­tem is able to lim­it the infec­tion at the lev­el of the lungs, and they are more like­ly to devel­op pul­monary tuber­cu­lo­sis. Fac­tors of infec­tion with tuber­cu­lo­sis are poor nutri­tion, lack of vit­a­mins, gen­er­al phys­i­cal weak­ness.

Tuber­cu­lo­sis can be divid­ed into two forms: pul­monary and extra­pul­monary.

The fol­low­ing forms of pul­monary tuber­cu­lo­sis are dis­tin­guished:

• focal
• infil­tra­tive
• cav­ernous, etc.

Forms of extra­pul­monary tuber­cu­lo­sis:

• tuber­cu­lo­sis of the gen­i­touri­nary sys­tem;
• tuber­cu­lo­sis of the diges­tive sys­tem;
• tuber­cu­lo­sis of the cen­tral ner­vous sys­tem;
• tuber­cu­lo­sis of bones and joints;
• tuber­cu­lo­sis of the skin and eyes.

Accord­ing to the form of the course of the dis­ease, open and closed forms can be dis­tin­guished. The open form of pul­monary tuber­cu­lo­sis is char­ac­ter­ized by excre­tion into the causative agent of the dis­ease into the exter­nal envi­ron­ment along with spu­tum. A patient with an open form should fol­low the doc­tor’s rec­om­men­da­tions to avoid infect­ing oth­ers: use indi­vid­ual dish­es that should be stored and washed sep­a­rate­ly, car­ry a spit­toon with a tight-fit­ting lid and spit spu­tum only there, wash your linen sep­a­rate­ly from the gen­er­al one, etc.

Symp­toms

Tuber­cu­lo­sis symp­toms are var­ied and non-spe­cif­ic: weak­ness, fatigue, sweat­ing, slight fever, chills. Often the child is wor­ried about cough­ing — from a slight cough to severe attacks with spu­tum and blood. In mild forms of pul­monary tuber­cu­lo­sis, the symp­toms may be mis­tak­en for those of the com­mon cold. Par­ents should be alert­ed by a cough that lasts more than three weeks in a row, loss of appetite, decreased atten­tion, fever for no appar­ent rea­son for a long time.

Tuber­cu­lous menin­gi­tis or mil­iary tuber­cu­lo­sis has more char­ac­ter­is­tic symp­toms: impaired con­scious­ness, short­ness of breath, high fever.

Diag­no­sis

The exam­i­na­tion begins with the detec­tion of extra­pul­monary forms of tuber­cu­lo­sis. The doc­tor deter­mines whether there is pain, bone defor­mi­ty, swelling in the abdomen. A char­ac­ter­is­tic symp­tom of tuber­cu­lo­sis is weight loss.

The main method for diag­nos­ing pul­monary tuber­cu­lo­sis is an X‑ray exam­i­na­tion. Spu­tum tests are car­ried out, a Man­toux skin test is done. If the diag­no­sis of pul­monary tuber­cu­lo­sis is con­firmed, treat­ment begins imme­di­ate­ly.

Treat­ment

Treat­ment of acute pul­monary tuber­cu­lo­sis should take place in spe­cial­ized hos­pi­tals. Self-treat­ment is in no case unac­cept­able! Med­ical ther­a­py is well estab­lished and high­ly effec­tive.

The room in which the sick child is locat­ed should be bright and reg­u­lar­ly ven­ti­lat­ed. Floor, fur­ni­ture must be wet cleaned every day. If there are no spe­cial instruc­tions from the doc­tor, then in dry and calm weath­er, the child needs to spend more time out­doors. At the same time, it must be remem­bered that exces­sive expo­sure to direct sun­light on unpro­tect­ed skin can pro­voke an exac­er­ba­tion of the dis­ease. It is advis­able to con­duct treat­ment cours­es from time to time in spe­cial­ized dis­pen­saries locat­ed in dry and warm cli­mat­ic zones, remote from indus­tri­al cen­ters.

In the treat­ment of pul­monary tuber­cu­lo­sis, a com­plete bal­anced diet is extreme­ly impor­tant. Food should be high-calo­rie, rich in vit­a­mins. Every day you need to con­sume at least 60 grams of pro­tein, half of which should be pro­tein of ani­mal ori­gin.

The degree of phys­i­cal activ­i­ty of a patient who is on out­pa­tient treat­ment should be deter­mined by him­self, based on his capa­bil­i­ties. Exces­sive activ­i­ty through force is con­traindi­cat­ed. Mus­tard plas­ters, banks and oth­er phys­io­ther­a­peu­tic pro­ce­dures are not allowed.

If pul­monary tuber­cu­lo­sis pro­ceed­ed atyp­i­cal­ly and the diag­no­sis was made late, then sur­gi­cal treat­ment is some­times indi­cat­ed: blow­ing air into the pleur­al cav­i­ty or remov­ing part or all of the lung.

Pre­ven­tion

Pre­ven­tion of tuber­cu­lo­sis goes in two direc­tions: pre­ven­tion of the dis­ease in chil­dren who did not have tuber­cu­lo­sis and pre­ven­tion of the dis­ease in chil­dren who had con­tact with patients. In the first case, a BCG vac­cine is giv­en, which pro­vides immu­ni­ty.

In the sec­ond case, mea­sures to pre­vent tuber­cu­lo­sis begin after the onset of symp­toms of a pos­si­ble dis­ease. The child is pre­scribed a course of Iso­ni­azid at a dose of 5 mg / kg for six months.

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