Clinical presentation of tuberculosis in culture-positive children

Background. Because tuberculosis (TB) in children implies recent infection, children serve as sentinels for disease transmission within a community. D espite the significance of diagnosing tuberculosis in children, most cases are diagnosed on clinical evidence rather than laboratory findings. Methods. We analyzed the demographic and clinical presentation of 156 child ren with culture proven tuberculosis using Epi-Info Version 6. Results. Although the clinical characteristics of this population were gene rally consistent with those seen in previous studies, several unexpected re sults were observed. Boys were overrepresented in the group of very young c hildren (72% <1 year). Many of the children had coexisting diseases not kno wn to predispose to TB (37%). Cavitation, usually observed in older childre n, was seen in four children less than or equal to 1 year of age. Few child ren were homeless or HIV-infected, but many (42%) lived in female-headed ho useholds. Of the adult contacts at risk for TB, many (49%) were recent immi grants to the US. Overall 34% of the population was either foreign born or the children of recent immigrants. Conclusions. This series of 156 culture-positive children provides an under standing of the risk factors and clinical presentation of pediatric tubercu losis. The data emphasize the impact of the child's environment on the risk for tuberculosis.