Pleural tuberculosis in the child: study of 86 cases

ABSTRACT

Pleural tuberculosis remains an important health problem in spite of the efforts provided on a worldwide scale to limit its extension. To analyze epidemiologic, clinical, para-clinical and evolutionary aspects of this pathology. We report a retrospective study relating to 86 patients with pleural tuberculosis admitted during 3 years and 10 months period [2001-2004], to the paediatrics service of CHU Hassan II of Fes. The age of our patients was between 30 months and 15 years with a 9 years average age. Pleural tuberculosis is frequent in older child and teenager with 46.5% of the cases between 6 and 10 years and 38.4% of the cases between 11 and 15 years. It relates to the male sex in 65.1% of the cases with a sex ratio of 1.86. The delay of diagnosis remains relatively important with 60.5% of consultations beyond the first month of evolution of clinical symptoms. This delay can be explained by clinical polymorphism, and the low socio-economic level of the majority of the patients. The radiological aspect comprises in 51.2% of the cases a pleurisy of average abundance and in 33.7% of the cases a pleurisy of great abundance. The right localization relates to 57% of the patients. The pleural puncture is useful for the orientation of the diagnosis by finding a liquid of the exudate type in 100% of the cases and with lymphocyte prevalence in 93.6% of the cases. The pleural biopsy is crucial for the final diagnosis of the pleural tuberculosis in 72.9% of the cases. The bacteriological examinations are positive in 5.8% of the cases for the direct examination and in 25% of the cases for the culture. The anti-bacillary treatment. is efficient in main cases with few side effects in the child when doses are respected. The pleural tuberculosis of the child remains frequent in Morocco. Its diagnosis is directed by the clinical examination and the chest radiography. The pleural biopsy is important for histological confirmation of this pathology