Tuberculosis is an infectious disease of the body, the causative agent of which is the bacterium Koch bacillus, named after its discoverer. Symptoms of this disease do not develop immediately, that is, it has an incubation period of 3 months to 1 year.
This the disease is characterized by the presence of specific tuberculosis formations. The target organs can be the lungs, kidneys, brain, intestines, eyes. It affects both adults and children.
Childhood tuberculosis It is especially dangerous because it is more difficult to tolerate and has a lot of consequences.
The cause of tuberculosis is the contact of a child with a sick person. As a rule, this is one of the family members. The disease is transmitted by airborne droplets, household, nutritional means, as well as from mother to fetus. Contributing factors may include:
- decreased immunity due to frequent colds, HIV infection, therapy with hormonal and antibacterial drugs;
- absence active immunity which occurs if the child has not received the appropriate vaccination;
- unfavorable social environment.
Pathogenesis of the disease
Mycobacterium tuberculosis has significant resistance both in the environment and in the human body.
Covered with a protective shell, the tuberculosis bacillus can exist in the body of the carrier and not cause disease, provided there is good immunity.
Invading the human body, mycobacteria first of all enters the lymphatic system, and lymphocytes are the first cells that fight it. If they fail to cope with the task, the pathogen enters the bloodstream and spreads to the organs through the bloodstream.
Settling in the target organ, the pathogen forms a caseous accumulation of cells in the form of a bump - a granuloma. It differs from granulomas that accompany other diseases by the presence in the center of a necrotic lesion that has the consistency of cottage cheese. When these formations burst, many Koch bacilli scatter throughout the body or enter nearby tissues of the affected organ. The burst formation begins to disintegrate, and then thickens, scars and calcifies, that is, becomes covered with calcium salts.
The first signs of tuberculosis in children
At the beginning of its development, the disease does not cause any symptoms, that is, it is in the prodromal phase. It can last from 6 months to a year.
The only sign may be positive reaction Mantoux.
After a latent period, the child begins to show the first symptoms of the disease. They manifest themselves as tuberculosis intoxication:
- decreased child activity;
- dizziness, headaches;
- poor appetite, weight loss;
- temperature: against the background of low-grade fever, temperature flashes up to 39° flash;
- increased sweating, especially at night. The palms and feet in particular sweat profusely;
- enlargement of lymph nodes of several groups. They are soft and painless.
Data primary signs are a manifestation of all types of tuberculosis.
Symptoms
After the stage of tuberculosis intoxication, the primary tuberculosis complex develops. It can form in any organ, but the lungs are most often affected.
In this case, bacteria, choosing the most well-ventilated area of the lungs, accumulate in it and cause an inflammatory focus. It grows, and the pathogens move to nearby lymph nodes, causing inflammation there too. Typically, this process develops in children with low immunity. It can heal on its own.
Signs of pulmonary tuberculosis in children in the early stages of the disease are the same symptoms of intoxication, an increase in body temperature to 37.5°. Often the onset of the disease can be confused with a respiratory infection.
Patients experience shortness of breath and cough. A child’s cough with tuberculosis varies in duration – more than 3 weeks. At the beginning of the disease it is dry, then gives way to wet.
A characteristic sign is the production of sputum with blood.
These children are very thin, pale, and their cheeks are flushed. A painful shine appears in the eyes.
When the lymph nodes of the mediastinum and the roots of the lungs are involved in the process, bronchoadenitis develops. The above symptoms are accompanied by painful sensations between the shoulder blades, a rough, whistling exhalation as a result of compression of the bronchi or trachea by enlarged lymph nodes.
Cough also accompanies this pathology. It is dry and paroxysmal, reminiscent of whooping cough. A venous pattern appears in the upper part of the chest.
Classification by localization
Tuberculosis is a disease that can affect any organs. It all depends on where the mycobacterium gets through the bloodstream. Depending on the affected system, there are several types.
Pulmonary tuberculosis , including:
- Primary tuberculosis complex.
- Bronchoadenitis.
- Tuberculosis of the bronchi, lungs, upper respiratory tract y.
- Tuberculous pleurisy.
- Pulmonary tuberculosis:
- focal- formation in lung tissue small areas lesions (within 1 segment);
- cavernous- a cavity forms in the lungs without signs of inflammation;
- fibrocavernous. There is a compaction of the cavernous cavity and nearby lung tissues;
- cirrhotic- lung tissue is replaced by connective tissue, causing the lung to lose its elasticity;
- disseminated- a severe form of tuberculosis infection, in which multiple focal lesions appear in the lungs. Then the infection travels through the blood and lymph to other organs;
- miliary- a type of disseminated tuberculosis, in which multiple foci that form in the lungs are small in size;
- infiltrative- characterized by the formation of an area of inflammation in the lung tissue with necrosis in the center;
- tuberculoma- this is tuberculous inflammation in a capsule larger than 10 mm.
Symptoms and treatment of pulmonary tuberculosis in children depend on the location and severity of the process. But still, the signs of manifestation are similar to each other: cough, hemoptysis, shortness of breath, chest pain.
Tuberculosis meninges . The most common form is tuberculous meningitis. In this case, damage to the membranes of the brain occurs. The process is accompanied by severe headaches, mood lability, high fever, vomiting, and muscle hypotension.
Tuberculosis of the musculoskeletal system in turn is divided into:
- spinal tuberculosis— the process at the beginning of the disease is limited to 1 vertebra. Therefore, intoxication and pain syndromes poorly expressed. As the process progresses, symptoms increase. Appear sharp pains in the spine of a different nature and tension of the vertebral muscles. To reduce pain, a person takes a forced position. His posture and gait change. Severely deformed rib cage, curvature of the spine develops;
- joint tuberculosis characterized by pain in the affected joint area. The skin over it is dense, hot to the touch, and swelling is pronounced. First, there is difficulty in flexing and extending the joint, then it becomes completely immobile. The general condition is disturbed;
- bone tuberculosis accompanied by pain in the bones, and, as a consequence, dysfunction of the organ. It should be noted that the cause of tuberculosis of the skeletal system, in addition to the general
The cause of tuberculosis is overload of the musculoskeletal system.
Kidney tuberculosis . Its symptoms are painful sensations in the back, pain when urinating, blood in the urine, disturbance general condition.
Lupus. The most common type among children is skin symptom, like a tuberculous chancre: first a reddish lump appears on the skin, which then turns into an ulcer. It is painless, but the lymph nodes located near it become inflamed.
Another type of childhood skin tuberculosis is its change in the area of the affected lymph node. The skin over it becomes blue, then ulcerates. Such formations are painless. Small bumps may also appear on the face and neck. If you press on them, they turn yellow.
Tuberculosis of peripheral lymph nodes in children it is accompanied by painless enlargement. They are mobile. As inflammation increases, they rupture, forming a fistula with purulent discharge. Hyperthermia up to 40° and headaches appear. The submandibular, chin and cervical lymph nodes are most often affected.
Intestinal tuberculosis accompanied by abdominal pain, disturbances of intestinal motility, bloody stools, and hyperthermia. The general condition is also disturbed.
Tuberculosis of the eye causes decreased vision, photophobia, and tearfulness. Blackness or blurred vision and pain appear.
It is important to know that tuberculosis can occur in an open form, that is, with the release of Koch bacillus in environment, and, consequently, with further infection of people in contact with the sick person. It can also be in a closed form, in which bacteria do not enter the external space.
Features of tuberculosis in children and adolescents
Tuberculosis for children – extremely serious disease which leaves behind a number of complications.
Features of the course of tuberculosis in children under 2 years of age characterized by the particular severity of the process. As a rule, it is generalized. From the primary focus, pathogenic microorganisms travel through the bloodstream to other organs, significantly complicating the child’s condition. Such children often develop disseminated, meningeal tuberculosis and even sepsis.
In older children the immune system is more advanced. It allows you to localize the process, preventing its generalization. They are characterized by tuberculosis of the lymph nodes.
How younger child, the worse he suffers from the disease. This is due to the feature child's body: his immune system is still immature, unformed, because of this it cannot fully resist infection.
The next critical age for the development of the disease is adolescence. It is also characterized by diffuse forms of infection, affecting the lungs and brain. This is due to hormonal surges that lead to an imbalance in the body, and, as a result, a reduced ability to resist the disease.
A form of the disease that occurs only in children is congenital tuberculosis.
Infection of the fetus occurs from a sick mother through the placenta or when the child swallows amniotic fluid. In this case, the pathogens of the disease are primarily transferred through the bloodstream to the baby’s liver, where the initial focus of the pathological process is formed.
These babies are born premature. After a month, the first symptoms of the disease begin to appear: hyperthermia, depression or anxiety. Symptoms develop very quickly respiratory failure. Often the infection causes inflammation of the lining of the brain. In this case, there are signs of damage to the central nervous system, tension occipital muscles, discharge from the ears.
The most common type of childhood tuberculosis is damage to the lung tissue. Pulmonary tuberculosis in children occurs in 80% of cases. Therefore, the appearance of a cough in a child, which does not go away within a month, and an increase in temperature should alert parents and become a signal to examine the baby.
Most effective method to prevent tuberculosis is the BCG vaccine. It is a weakened strain of the tuberculosis bacillus. Vaccination for newborns is less aggressive. The BCG-M vaccine is used for it. The first vaccine against tuberculosis was made in France in the 20s of the 20th century.
Timing of BCG vaccination:
- carried out in the maternity hospital for newborn babies on days 3-7 of life;
- RV1 (that is, 1 revaccination) is carried out at 7 years;
- RV2 is performed at 14 years of age in healthy children.
Immunity after BCG vaccinations is formed after 2 months and protects the child from tuberculosis for 4 years. This is especially important for young children, since tuberculosis can be a fatal disease for them.
The vaccine is given intradermally in the upper outer third of the shoulder.. First, a slight swelling appears at the injection site. Then it turns into a pustule - a bubble with liquid. The pustule bursts, forming a small ulcer. The ulcer becomes crusty. After 6 months, a scar forms in its place. He should be 5-8mm in size. This indicates successful vaccination.
Sometimes after vaccination there is no trace left. This may indicate innate immunity to the disease.
Complications after receiving the tuberculosis vaccine may include::
- cold abscess;
- BCGit;
- keloid scar.
Contraindications to BCG:
- if among the child’s contacts there are patients with tuberculosis;
- if the mother is diagnosed with HIV infection;
- diseases nervous system;
- any acute diseases;
- immunodeficiency; neoplasms;
- prematurity; body weight less than 2.5 kg;
The diagnosis of the disease is the Mantoux reaction. This is not a vaccine that protects your child from the disease. This is an indicator that shows whether the baby is sick or not.
The Mantoux test is placed in the middle third of the forearm. Tuberculin is injected, which is a filtrate of killed mycobacteria. It contains tuberculoprotein, which acts as an allergen. The drug is administered intradermally, and a “lemon peel” forms at the injection site.
The result is assessed no earlier than after 48 hours:
- if a compaction (papule) less than 5 mm in size has formed at the injection site, this indicates a negative reaction;
- 5 mm-10mm – the reaction is doubtful;
- if the size of the papule is more than 10mm, then the reaction is considered positive and may be a sign of tuberculosis.
It is advisable not to wet or rub the “button” formed after grafting.
It should be noted that a positive Mantoux test can be observed in healthy children within 1-2 years after BCG.
Contraindications for the Mantoux test:
- hyperthermia;
- allergies in the acute stage;
- convulsions;
- skin diseases;
- quarantine.
Diagnosis and tests for tuberculosis
Diagnosis of the disease is aimed at identifying pathogenic bacteria in the body’s environments, as well as in target organs.
Early identification of the disease helps to cope with it as quickly as possible. a short time with minimal damage to the body.
Diagnosis of tuberculosis in children is very rarely goes without the Mantoux reaction. It is carried out annually, starting from 1 year of age. It allows you to identify the disease in the early stages of the disease. And also those people who are carriers of this infection, but do not get sick themselves.
Other research methods include:
- Fluorography, radiography, tomography.
- Bacteriological method. It consists in identifying the pathogen in various environments of the body. First of all, it's phlegm. As well as punctate from pleural and abdominal cavities, joints, lymph nodes. Can be used for analysis cerebrospinal fluid, contents of wounds and fistulas, blood, urine. Modern method bacteriological research is PCR diagnostics. This is a fairly sensitive method. A small amount of bacteria is enough to carry it out. Suitable for studying any body fluids. It involves identifying the DNA of a bacterium. This procedure is so accurate that it can detect the disease when other tests are negative.
- Bronchoscopy.
- Biopsy of the affected organ. Most often performed during diagnostic operations, when other methods are of little value. Most often this is a biopsy of lymph nodes, as well as lung tissue when opening the chest.
Treatment
Treatment of tuberculosis in children quite long. It is aimed at suppressing the development of tuberculosis bacillus and restoring the affected organ.
Treatment of identified tuberculosis begins in a hospital when bacteria are concentrated in the extracellular space. The person is contagious.
Stage 1 of treatment – taking anti-tuberculosis drugs. These include: rifampicin, isoniazid, pyrazinamide, ethambutol and others. They are the most effective and least toxic. The treatment regimen must contain at least 3 such drugs. Antibacterial therapy is also used.
Also widely used physiotherapeutic treatment methods. For exudative and necrotic inflammation, UHF therapy, inhalation, and electrophoresis are indicated. In the future, ultrasound, magnetic therapy, and laser are used to resolve infiltrates, restore tissue, and heal wounds.
Required application immunostimulating drugs to increase the body's resistance to fight infection.
The patient must maintain an appropriate regimen, eat a balanced diet, healthy image life.
When the stage of the disease enters a closed form, treatment of tuberculosis at home under the supervision of a phthisiatrician is allowed.
When useless conservative treatment apply surgical methods . This may involve removing part of an organ or affected area.
Treatment of tuberculosis is a fairly extensive process that requires patience and correct implementation of all its stages. It is complex, that is, it affects the body from all sides in different ways. It must be remembered that the earlier the disease is detected, the easier and faster it is to cope with it.
Prevention of tuberculosis in children and adolescents
Prevention of tuberculosis for a child begins in the maternity hospital with the first BCG vaccination.
Vaccination is an important, and probably the most important step in preventing the development of the disease. And you shouldn't neglect it.
Boosting a child's immunity– the second most important stage of prevention. Balanced, fortified nutrition, hardening, correct mode work and rest are the key to a healthy life for a child.
Also plays a role in preventing the development of the disease. early detection infected people and their temporary isolation to prevent infection of a healthy part of the population.
Tuberculosis is a rather complex disease and, unfortunately, is highly contagious. Every year the number of people infected with this disease is growing. That is why the prevention of tuberculosis is given such great attention . After all, it is much better to strain the immune system than to endanger the life of a child.
Treatment and prevention of tuberculosis in children
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Today, treatment of tuberculosis in children is a complex procedure that requires professional approach. This disease causes specific infectious and inflammatory tissue damage. Tuberculosis has different shapes and can develop secretly.
The tuberculosis pathogen is highly resistant to drugs. Microbes retain their vital activity for a long time in a dried mass of sputum for 1 year, in dust for 60 days, in water for about 4-5 months. It is worth noting that the tuberculosis bacillus is afraid of direct sunlight and dies in a couple of minutes.
But the tuberculosis bacillus cannot be underestimated. It is resistant to many disinfectants. For example, microbes live in a chlorine solution for more than 6 hours. This proves that it is easy to contract a disease, but much more difficult to cure it.
How does tuberculosis become infected?
Eat different ways picking up the infection today.
Drip-air
If patients who have open form tuberculosis, they talk, cough, sneeze - they infect others. Bacteria enter the child’s body and weak immunity are starting to develop. It is worth remembering that when sneezing, bacilli are transmitted over a distance of about 9-10 m, while coughing – over 2-3 m. If a child inhales air that is contaminated, then infection occurs. Microbes enter the lungs and develop.
Infection due to dust
If there is strong air movement, the tuberculosis bacillus microbes lying under a layer of dust rise into the air. They can enter the child's lungs with every breath and develop there.
Propagation via contact path
There are times when a child, without knowing it, can become infected through contact with a sick person without washing his hands or rubbing his eyes. The bacillus enters the mucous membrane of the eyes and then begins to develop.
Disease transmission through the food route
The cases in question are rare. This manifests itself when eating foods contaminated with tuberculosis. Attention should be paid to meat and milk. If the animal is infected, then the milk or meat is infected. 
Why are children more at risk?
Statistics show that those children and adults who are malnourished or live in unsatisfactory conditions can get tuberculosis. Such statements are partly true for tuberculosis patients. But, young children are at greater risk of becoming infected than adults because they have not yet experienced age-related changes and an immature immune system.
Why are children more likely to become infected?
- Due to insufficient ventilation of the lungs - this is explained by the peculiarity of the structure respiratory system. Trachea and Airways The upper part of the lungs is short, but at the same age the bronchi have a narrow and elongated structure.
- Young children have not yet developed the cough reflex.
- The body's defense system is not yet developed.
- When tuberculosis bacteria are captured by phagocytes, complete digestion does not occur; part of the infection remains in the body.
- Insufficient mucus secretion because the mucous glands are not fully developed.
The child must be protected, taking into account many situations of infection. At the first suspicion of illness, it is important to consult a doctor.
How do teenagers get infected?
- During neuroendocrine restructuring of the body protective system may be delayed in development, so the infection may begin to develop.
- Intensive growth of lung segments occurs, so the tissues are not fully able to cope with their functionality.
- IN adolescence bad habits, including smoking, contribute. Such factors lead to a weakening immune system. In addition, with an expanded circle of contacts, it appears increased risk infection.
It is important to take into account all the factors considered so that infection does not occur during adolescence.
What should parents pay attention to?
Tuberculosis is an insidious disease that is well disguised. It can manifest itself in the form of symptoms of other diseases, although they are mild. Also, it is worth considering that everything depends on the affected organ and the intensity of the development of pathological processes.
Symptoms of the disease become pronounced at the age of 8-9 years; as for adolescence, the disease can manifest itself in different ways.
General symptoms by which the disease can be identified, but treatment and prevention are prescribed only after a qualitative examination. 
Intoxication is detected by the following disorders of the central nervous system:
- Severe anxiety in the baby early age for no reason. He sleeps poorly, is very moody and cries often.
- In to school age The baby becomes quickly tired, irritable, inappropriately reacts, or displays aggression.
- At school age, a child does not absorb materials well and becomes inattentive. Memory lapses occur when the form is advanced. A boy or girl begins to get nervous because of an ordinary little thing, for example, because of a broken pen.
The functioning of the gastrointestinal tract is disrupted
The infected person eats poorly (he doesn’t feel like it), and his digestion is impaired. An alarming symptom for infants is an increase in stool frequency and frequent regurgitation during feeding (a manifestation of dyspeptic disorders).
Weight loss
When infected with tuberculosis, an intensive process occurs in which proteins, fats and carbohydrates decompose. And when a child has a poor appetite, which is most likely the case, the rate of weight loss increases.
Appearance of body temperature
If infection has occurred and the disease has not yet progressed and is at an early stage, or in a form of tuberculosis called limited, the child has a normal temperature.
If fever occurs during tuberculosis, it has the following features:
- V evening time rises, remains constant during the day, falls in the morning.
- during tuberculosis in the evening the temperature is 37.2°C, and in the morning it is below normal 36.0-36.4°C;
- Unstable temperature readings during daily measurements.
- the fever may not subside for a long time.
- a person infected with tuberculosis experiences fever asymptomatically.
If the disease progresses, the temperature may rise to 37.5°C. Sometimes, the temperature becomes stronger and the thermometer stops at 38.5-39.2°C.
Pathological processes in the respiratory organs
Tuberculosis in children exhibits different symptoms. It is important to notice them and contact a phthisiatrician or pediatrician in time.
Cough
Cough is not one of the main symptoms of tuberculosis in children; for this reason, at the beginning of the disease, it can manifest itself without strong expressions.
- cough is prolonged (more than 4 weeks), may worsen at night;
- V adolescence it can be dry or with little sputum;
- in preschool and school age, the cough is dry and whooping cough, in the form of attacks or spasms;
- In young children, cough has two tones.
Sputum production
In children, its secretion is reduced and may even be absent altogether. When sputum is produced, the infected person swallows it.
Spitting blood
This phenomenon is rare in children, but is noticed in adolescence, during an advanced form of tuberculosis.
Shortness of breath and difficulty breathing
If the pathology is early stage– shortness of breath and difficulty breathing are absent. If the disease begins to progress, this entails the development of complications in the form of pleurisy, miliary tuberculosis and other manifestations.
Pain in the chest area
Basically, the pain does not appear, but with deep inhalation, it may become more pronounced.
Increased sweating
If everything is in order with the body, then practically no sweating occurs. But when infected with tuberculosis, sweat glands They work in an intensive mode, and the baby constantly remains wet from the back. Also, his palms often sweat. Increased sweating is observed at night.
Enlarged lymph nodes
When suffering from tuberculosis, the lymph nodes immediately enlarge at any age; they are located in the root of the lungs. The tone of the cough depends on the degree of magnification.
In more advanced forms of tuberculosis, enlargement of the lymph nodes under the arms occurs. The peculiarity is that when enlarged they do not hurt and remain soft.
This is not the whole picture of symptoms associated with tuberculosis. It all depends on which organ is damaged, what degree of disease and at what age the patient is. Damage can occur both in the intestines and in bone tissue or in the lungs. It is worth noting that tuberculosis can cause symptoms similar to ARVI or bronchitis.
What can be done if suspicion arises?
If parents have the first alarming suspicion that their child is sick, it is important to go to the hospital for help. Basically, the first request will be reviewed by a pediatrician, who will refer you for further examination, since all suspicions should be confirmed using diagnostic methods.
The main thing is to remember that tuberculosis cannot be treated on your own, with the help of antibiotics. As mentioned above, the tuberculosis bacillus can resist many drugs. For this reason, if tuberculosis therapy in children and adolescents is carried out incorrectly, complications in the future are guaranteed.
Today, medications that help overcome the tuberculosis bacillus are far from being as harmless to the body as they seem. 
How to confirm the diagnosis
Diagnosis is carried out under the guidance of a phthisiatrician. To properly confirm concerns and check the child’s condition, you will need:
- urine composition tests;
- blood tests;
- do X-ray lungs;
- conduct a sputum examination.
During the diagnosis test, a test called Mantoux is used. The test is carried out to determine the sensitivity of the child’s body to the tuberculosis bacillus.
But this definition is not accurate. The test proves that the bacillus is in the body, but it is contained by the immune system.
If there are unfavorable factors in the form of stress, colds and other negative impacts on the body - the wand of this terrible disease can wake up and become activated and the disease will begin to develop.
How to treat tuberculosis in children?
During treatment, the infected person must take a course of anti-tuberculosis drugs. medicines. In other words, all treatments for tuberculosis in children are considered serious chemical process, attacking the organism, its goal is to suppress the bacillus (microbes). But, despite the positive effects of such drugs, there is a risk of side effects, since medications can also act on other organs of the child’s body.
The first to suffer is the digestive system. For this reason, in parallel with the course of treatment, bifidobacteria are prescribed, designed to protect the organs of the digestive tract. Doctors prescribe hypoprotectors to preserve the liver during tuberculosis treatment.
Prevention of tuberculosis in children should be carried out regularly. The child’s immune system must be supported with the help of many available ways. You can start with using immune system stimulants and end with using a simple bee propolis tincture. The main thing is that the boy or girl tolerates the treatment and does not experience any difficulties with functioning internal organs.
When fighting against tubercle bacilli, it is important to follow a special diet, enriched necessary vitamins. The diet should contain vitamins of groups “E”, “B” and “C”. Also, the composition should contain minerals and trace elements. To get good results during treatment, you can contact a nutritionist who will prescribe the right diet.
How folk remedies can help
A folk remedy that can help with tuberculosis is juice extracted from black radish. It must be mixed with honey. Previously, such a tool was considered one of the most practical folk remedies, since there were no other drugs. Today, such a composition should also be used during preventive measures.
When symptoms appear and treatment is carried out on time, the likelihood of successful recovery increases. In any case, the decision on tuberculosis treatment should be made exclusively by specialists, taking into account the opinion of parents; self-medication is not permitted. The child's condition requires frequent diagnostic studies to prevent relapse. This must be done, since tuberculosis is a tenacious and persistent pathology.
Drugs used in the treatment of tuberculosis in children
Medicines to combat the disease in question do not differ by age category. That is, isoniazid is used for both adults and children. Basically, he is given preference. In any case, hospital treatment is required.
Use of Rifampicin
Rifampin is available in tablet or capsule form. It is well tolerated by children of any age if the recommended doses are observed. As side effects appears:
- vomiting occurs;
- nausea appears;
- headache;
- intestinal disorder.
Saliva and urine change color to red, this applies to sputum. The drug should be taken 20 minutes before eating.
Pyrazinamide and its uses
Pyrazinamide is available in tablet form. Its effect during the fight against tuberculosis is well tolerated by children. As side effects appear:
- dizziness;
- poor appetite;
- Bad mood;
- decreased activity;
- burning sensation of the skin.
A phthisiatrician prescribes medications. Therapy occurs over a period of 6 months to 1 year. The consolidation course lasts about 2 years.
Preventive actions
Tuberculosis is easier to treat in initial stage rather than later deal with its advanced form. It is worth remembering that a stick, once it enters the body, can remain in it for a long time. But when acceptable conditions appear, it immediately begins to develop, making itself felt.
Doctors regularly vaccinate against the disease. Ignoring vaccinations is not recommended.
Specific preventive actions are carried out from the very beginning of a child’s life and ends in adolescence. Important, when determining hidden processes in a child’s body, systematic diagnosis and the attention of parents play a role.
Tuberculosis is bacterial infection, which can develop into various organs and human systems. The causes and routes of infection with tuberculous mycobacteria vary, but the most dangerous infection is for children, the elderly and those with weakened immune systems.
When the first signs of tuberculosis are detected in children, a differentiated diagnosis is prescribed, which includes tuberculin test, radiography and other studies.
How to test a child for tuberculosis
Risk factors for tuberculosis infection in children are constant contact with patients with an active form of pathology, immunosuppressive therapy, immunodeficiency conditions, poor hygiene, etc.
Newborns may develop a congenital form of infection, which is caused by intrauterine infection or transmission of mycobacteria from a sick mother during childbirth.
It is difficult to immediately determine the presence of infection, because In the early stages, tuberculosis can be practically asymptomatic or cause nonspecific clinical picture. Incubation period can last from two weeks to three months. With a short duration of the asymptomatic period, the prognosis for the recovery of children worsens significantly.
Symptoms
Childhood tuberculosis is accompanied by symptoms such as:
- low-grade fever(+37...+38°C), which persists for several weeks;
- heavy sweating during night sleep;
- tachycardia;
- malaise, fatigue, weakness, shortness of breath, less often - headache;
- sleep disturbances, irritability;
- loss of appetite, disturbances digestive process;
- pale, dry skin;
- swelling and hardening of the lymph nodes near the site of localization of mycobacteria (most often, immediately after the intrathoracic lymph nodes, the cervical and supraclavicular lymph nodes enlarge);
- a sharp decline weight, slower growth and development of the child;
- anemia, reduced level of leukocytes in peripheral blood analysis.
When tuberculosis develops in children, the symptoms depend on the form of the disease and the location of the pathogens in the body.
With local damage, signs of inflammation of a specific organ appear. Depending on the location of the accumulation of mycobacteria, the patient exhibits following signs diseases:
- With pulmonary tuberculosis in children, a persistent cough is observed, which gradually turns from dry to wet and intensifies at night or in the morning. The sputum discharge may have a white, yellow, green, or rusty tint. The latter option indicates the presence of blood, which is subject to oxidation inside the body. If left untreated, blood may appear in the sputum. Besides common symptoms intoxication, the child experiences noisy wheezing, chest pain and shortness of breath.
- With tuberculosis of the intrathoracic nodes, children experience severe shortness of breath, swelling of the nasal wings due to lack of air, and a persistent bitonic cough. The appearance of these symptoms is due to compression of the bronchi by enlarged lymph nodes. In adults, the symptoms of this pathology are less pronounced, because compression of the bronchi occurs only at late stages diseases. Damage to the lymph nodes is one of the most common forms of the disease in children. Tuberculosis of peripheral nodes is less common and is observed mainly in children over 5 years of age and adolescents.
- When the nervous system is damaged, hearing, vision and sleep disturbances are added to the signs of intoxication. Meningeal symptoms rapidly increase - nausea, vomiting, worsening headache, dizziness, hypertonicity of the neck muscles, convulsions. In infants, the fontanelle bulges. When lifting the child, he pulls the bent legs towards the stomach. Defeat spinal cord And cranial nerves can cause paralysis and paresis of the limbs. occurs predominantly in children under 3 years of age or with immune disorders (HIV, diabetes mellitus and etc.).
- The general condition of the child worsens only against the background of multiple lesions, as well as in the presence of an additional lesion in the lungs or thoracic lymph nodes. Early manifestation symptoms of intoxication are typical for infants or young patients preschool age. In most cases, tuberculous arthritis affects several joints at once, causing pain and limiting the patient's mobility. Infections of the bones and spine cause pain in the bones and back, deformities appear, and the risk of pathological fractures increases.
- Defeat urinary tract provokes lower back pain, the appearance of blood in urine, a decrease in the amount of urine (oliguria, dysuria), and less often, pain when urinating. Infection of the reproductive system is manifested by intoxication, pain in the lower abdomen and swelling inguinal lymph nodes. Intestinal damage provokes the appearance of blood in the stool, abdominal pain, nausea, stool and digestive disorders.
- accompanied by the appearance of small dense nodules under its surface. When enlarged, they rupture, releasing white, curdled contents. The formation of reddish-yellow dry patches, pustules, erosions and boils is possible.
- Damage to other organs and systems (for example, the middle ear, eyes, etc.) is observed less frequently. In these cases, the disease is accompanied by dysfunction of the corresponding organ and signs of intoxication. With miliary tuberculosis, foci of infection occur in several organs at once.
With a congenital infection, the infant experiences severe difficulty breathing, hepato- and splenomegaly (increased volumes of the liver and spleen), fever, low activity of movements and poor appetite.
Often these signs are combined with neurological symptoms, which indicate damage to the spinal cord and brain.
The immune response to the penetration of mycobacteria can be expressed in paraspecific reactions. These include: inflammation of the eyes (keratoconjunctivitis), nonspecific heart damage and joint capsules(myocarditis, pericarditis, synovitis), nephrotic syndrome and glomerulonephritis, the appearance of spots on the skin (vasculitis, erythema). These pathologies cause redness of the mucous membranes, shortness of breath, weakness, dyspepsia, swelling, decreased mobility and pain at the site of the reaction.
Tuberculosis, like every disease, has its own signs and symptoms. They relate to the general condition of the child and the results shown by the examination. It is impossible to say that any single symptom of tuberculosis in children is 100% a disease.
Sometimes parents are faced with the fact that if after Mantoux vaccination the trace is larger than the norm, children are suspended from school or prohibited from attending a group in kindergarten. The only “wrong” one doesn’t mean anything.
Mantoux can increase for many reasons.
- The graft was wetted or rubbed.
- They did whose condition was “borderline”, at the beginning or after the illness.
- In the presence of helminthic infestation.
- There is tuberculin, or the vaccination coincided with an allergy to another factor.
Symptoms of tuberculosis in children
The following are suspected in children (if they coincide in time of manifestation):
Each sign individually cannot be defined as a symptom of tuberculosis in children, but their combination should force you to consult a doctor.
If, upon further examination, a detailed blood test shows and an ultrasound of the internal organs shows that they are enlarged, we can talk about the disease.
This can only be determined by a doctor, after tests and examinations, including which were done with proper monitoring.
If there is an injection mark:
- at 2 years exceeds the size of the scar from BCG - vaccination against tuberculosis given at birth - by 6 mm, or a positive reaction;
- at 3-5 years the change becomes positive, or the spot itself with a formed papule of more than 12 mm;
- and by 7 it exceeds 14 mm, with an increase of 6 mm from the previous test,
then we can assume that this is a symptom of tuberculosis in children.
Tuberculosis infection
Most often, children become infected with Koch's bacillus - the tuberculosis bacillus - from adults suffering from the disease in an open form. It is quite possible to catch the infection through objects used by an infected person. Babies "absorb" infection from a sick mother.
The tuberculosis bacillus does not always attack the lungs. It spreads throughout the body through the bloodstream, settling in the spleen, liver, kidneys, brain and other organs, including the skeletal system.
You can see the symptoms of tuberculosis in children on x-rays. The photo, an x-ray, will show a picture that will accurately tell you about the presence of cavities in the lungs. X-rays also show the process developing in the kidneys and skeletal system.
Sometimes the child does not notice the manifestations of the disease for a very long time. This happens if the disease begins with sluggish form. Apart from excessive fatigue, which parents explain by children being overworked during classes, and weight loss, there are no other symptoms. Children complain that it hurts to walk, and they begin to look for arthritis and rheumatism. But there are times acute infection when the symptom of tuberculosis in children takes the form of seasonal viral infection, high T and cough appear, lymph nodes enlarge. All this lasts much longer than during the flu or acute respiratory infections.
If heat and cough lasts more than a week, you should definitely call a doctor. After 2 weeks, streaks of blood may appear in the sputum released when coughing, and it will be more difficult to treat such a disease. Tuberculosis, detected at an early stage, is treatable and does not cause complications.
Tuberculosis is often called " social disease”, explaining that its incidence is growing where not everything is good with living conditions.
With the deterioration of the socio-economic situation and the increase in the number of antisocial elements who do not undergo medical examinations, a large number of people become ill, and even more are at risk of further spread of the infection. And traditionally, those at risk are the most defenseless.
Basic information
Tuberculosis - infectious disease, caused by Koch bacilli (mycobacteria). Tuberculosis bacilli were discovered by the German scientist Robert Koch, who studied the disease, its symptoms and what provokes it, in 1882.
Koch proved that the disease has infectious origin. He found out high level survival of pathogens, their resistance to high and low temperatures, moisture, light and chemistry. Under natural conditions, mycobacteria can live for several months, being sheltered from direct sunlight; in dust they live for up to 10 days, in water for up to 5 months.
In addition to resistance to adverse effects external environment, the reasons why tuberculosis cannot be completely defeated are the following:
- Koch bacilli can live in the body for years without manifesting themselves, starting inflammatory process completely unexpected.
- The first symptoms are similar to those.
- Mycobacteria have the ability to mutate during the course of the disease, making it impossible to treat them with antibiotics.
Due to the “survivability” of the infection, tuberculosis is a very dangerous disease, the treatment of which is accompanied by great difficulties. Many patients never completely recover from this disease.
Causes of development, risk groups, danger
Infection of the body with Koch bacilli usually occurs when pathogenic particles released by coughing in a person with pulmonary tuberculosis enter the lungs through airborne droplets.
The cause of infection in children is close contact with a sick adult(relative). In addition to the aerogenic route, the body can receive mycobacteria:
- nutritionally (through the use of food products from infected animals);
- by contact (sometimes infection occurs through the conjunctiva of the eye);
- intrauterine infection (with an infected placenta or infection during childbirth).
The main reason for the development of tuberculosis in children is a vulnerable immune system, weak due to young age or other reasons:
- genetic predisposition;
- the presence of chronic infections (as well as HIV and AIDS);
- constant stress;
- poor nutrition.
There is a high risk of infection in children from disadvantaged families and those living in shelters or boarding schools.
Mandatory condition for treatment acute gastritis Children have a strict diet. You can learn about it and much more by clicking.
First and subsequent symptoms
In the early stages of development, pulmonary tuberculosis in children manifests itself very weakly, without obvious symptoms. Nonspecific symptoms - fever, chills, drowsiness and lethargy.
Sometimes specific signs appear:
- severe shortness of breath;
- lack of appetite, sudden weight loss;
- cough that does not go away for more than two weeks;
- expectoration of sputum;
- profuse sweating at night;
- chest pain.
Detection methods: how to recognize in a timely manner
It is difficult to detect tuberculosis in children of both infant and preschool age in a timely manner. And if babies are still vaccinated in the maternity hospital, which allows the body to protect itself until the immune system is fully formed, it makes the primary disease as easy as possible, but with children of kindergarten age everything is more difficult.
In preschool children, the manifestations of tuberculosis at an early stage are nonspecific: headache, fatigue, lack of appetite, fever or chills - all this is usually mistaken by parents for the onset of a regular flu. It is necessary to start sounding the alarm even when anti-inflammatory and antipyretic drugs do not bring any benefit.
Recognition is easier for schoolchildren, since they must be vaccinated annually at the most effective method detection of infection. Teenagers undergo X-ray examination, which allows them to “catch” the disease at an early stage. We wrote about other methods for diagnosing tuberculosis in children.
At the first suspicion of a child must be seen by a general practitioner, who will conduct the necessary examination, and if suspicions are confirmed, will refer you to a TB specialist.
It is important to remember: the open form of the disease in the absence of treatment leads to fatal outcome 50% of cases occur in just one or two years.
Early diagnosis and prevention measures for childhood tuberculosis:
Diagnostic activities
Specific symptoms such as inflammation of the lymph nodes, wheezing in the lungs, significantly elevated temperature in a child, parents should be forced to see a doctor. During the examination, the specialist will collect anamnesis (information about the family, living conditions, complaints, previous diseases) and prescribe tests for tuberculosis in children:
Based on the results of the examination, the doctor will decide on the need and scope of treatment.
How and with what to treat
Chemotherapy is the fundamental method of combating with tuberculosis in children and adults. It involves the patient taking a group of certain drugs in different combinations. This has a complex effect on Koch's bacillus, which is invulnerable to conventional antibiotics.
Drugs for treatment:
- Isoniazid;
- Pyrazinamide;
- Rifampicin;
- Ethambutol.
The listed drugs make up combination regimens that are both effective and do not provoke mutation of a drug-resistant form of the disease.
What to expect after treatment, prevention in children and adolescents
Treatment of tuberculosis is a long and complex process. Not only are they important strict adherence to doctor's recommendations and strict adherence to dosage regimens medicines, but also the creation of an appropriate environment for rehabilitation for the patient.
The person recovering must be in a psychologically comfortable climate, receive good nutrition taking into account dietary restrictions. The room where the recovering patient will live must be clean, ventilated, and protected from viruses and infections.
- regularly taking medications prescribed by a doctor, vaccination;
- periodic medical examinations;
- healthy lifestyle;
- optimal work/study activity.
The prognosis of a tuberculosis patient will be favorable if these conditions are met. One of them is strict adherence to the rules of prevention and rehabilitation. What matters is how timely the disease was detected and how effective the treatment measures were.
Clinical recovery is considered to be the healing of inflammation and the disappearance of specific symptoms, however, in places where inflammation is localized, “dormant” bacteria may persist, which can provoke a relapse of tuberculosis.
Even with the most favorable outcome Patients after recovery they remain on the dispensary register with the need for regular examination.
Learn more about the disease from a detailed video program:
Parents should closely monitor the health of their children. Of course, you don't need to count every sneeze. fatal disease, but symptoms that do not disappear after taking the usual set of medications should attract attention. Although modern pharmacology makes it possible to successfully combat tuberculosis, it still remains one of the most dangerous diseases in the world.
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