Clinical and radiological analysis of children and adolescents with tuberculosis in Bahia, Brazil

ABSTRACT

We reviewed the clinical and radiological characteristics of tuberculosis (TB) in children and adolescents at the Hospital Especializado Octávio Mangabeira, (HEOM) in Salvador, Bahia. This study included 275 TB patients aged 1 to 15 years seen between January 1990 and November 2001. Standardized forms were filled out on the basis of a review of patient records and x-rays. Through a retrospective and descriptive analysis, it was found that 51.6 percent were male, 35.3 percent were aged 1 to 5 years, 28 percent were aged 6 to 10 and 36.7 percent were aged 11 to 15. Among all patients, 79.6 percent lived in the city of Salvador. A history of contact with TB was found in 63.9 percent, most frequently among children under 5 years old; 77.2 percent were vaccinated with Bacillus Calmette-Guerin (BCG). The most frequently observed symptoms were coughing (76 percent), fever (73.1 percent) weight loss (53.1 percent), and 4.7 percent were asymptomatic. Pulmonary TB was most frequent (57.8 percent) and extra-pulmonary TB occurred in 24.4 percent, with a predominance of hilar adenopathy. Both forms occurred simultaneously in 17.8 percent. In 53.1 percent of the cases the diagnosis was not determined by bacteriology or pathological anatomy; in these cases diagnosis was reached through clinical and radiological criteria, contact history, a tuberculin test >10mm and a positive response to tuberculostatic drugs