ABSTRACT
Background: Lung abscess is a rare and jeopardizing disease particularly in children. Early diagnosis of the disease can prevent further complications. Delay in diagnosis not only increases the mortality, but also can lead to severe complications along with the need for surgical intervention. Hence, we decided to evaluate the clinical and para-clinical features of our cases to estimate the magnitude of the problem
Materials and Methods: Data was obtained based on a retrospective study from 1992 to 2004, during a 12-year period in our centre. All the children who were admitted in NRITLD with lung abscess were enrolled in the study. Data was collected and analysed considering their age, gender, underlying disease, and aspiration history
Results: A total of 17 children were identified including 12 boys and 5 girls. 12[70%] children were under 10 years of age. Nine had a history of interstitial lung disease while 12 children had history of aspiration. The most common complaints were cough [94%], fever [82%], and sputum [82%]. Leukocytosis was observed in 76.5% of the cases while 70% showed shift to the left in their blood analysis. 60% of the cases were diagnosed only by CT-scan without any other evaluation. Gram positive organisms [Streptococcus pneumonia 11.6% and Staphylococcus aureus 5.8%] were the most prevalent organisms involved in our cases
Conclusion: According to this study, lung abscess is more prevalent in boys. The most common symptoms are cough, fever, and sputum. Furthermore, we suggest CT scan for diagnosing the disease because of its valuable role in detecting lung abscess in early stages
ABSTRACT
Background: Increased rates of multidrug-resistant tuberculosis [MDR-TB] have been reported from developing countries. We evaluated the incidence of drug resistance in children in order to determine the magnitude of the problem, in our region
Objective: To determine the resistance pattern of Mycobacterium tuberculosis to four anti-tuberculosis drugs in childhood pulmonary tuberculosis at National Research Institute of Tuberculosis and Lung Disease [NRITLD] which is a referral centre in Tehran. Treatment of the patients was based on the DOTS strategy according to the WHO protocols since 1989
Materials and Methods: Retrospective analysis of all cases of pulmonary tuberculosis with positive M. tuberculosis culture who had referred to paediatrics ward from January 1999 to August 2004. M. tuberculosis sensitivity testing was performed by the Lowenstein-Jensen medium for isoniazid [INH], rifampicin [RMP], streptomycin [SM], and ethambutol [EMB]
Results: Among 350 children [0-15years] with confirmed tuberculosis, 7 children had resistance to at least one of the four anti-TB drugs. Out of the 7 patients, 6 were Afghan refugees and one patient was Iranian. Among those 85.7% had resistance to RMP, 71.4% to INH, 57.1% to SM, and 28.6% to EMB .In addition, 28.5% of patients had resistance to all four drugs [RMP, INH, SM, EMB], 14.2% to INH, RMP, SM, 28.5% to INH, RMP and 14.2% had resistance to each of SM and RMP. In this study 2% of children with TB had resistance out of which primary resistance was detected in 57.1%. Secondary resistance was found in 42.9% of cases who had previous history of anti-TB therapy
Conclusion: According to 2% prevalence of drug resistance in children and high resistance to RMP in our study, more aggressive interventions should be considered. Further management and supervision in DOTS implementation is highly recommended to prevent transmission of resistant tuberculosis