The clinical and radiological features of tuberculosis in adolescents

This retrospective review of clinical records and chest radiographs (CR) of adolescents aged 10-18 years was designed to determine age and sex differe nces in the clinical and radiological features of adolescent tuberculosis ( TB). Records of adolescents who were admitted to Brooklyn Hospital for Ches t Diseases (BCH) or who were treated at local authority health clinics were screened. Data from 324 adolescents (male:female ratio 1:1.2) were studied . Intra-thoracic lesions were present on CR in 306 (94%). Primary TB with m ediastinal adenopathy was present in 32 (10%). Cavitation was present in 18 0 (56%), 16% at 10 and 73% at 18 years of age. Cavitation occurred in 55% o f males and in 56% of females with increasing frequency from 15 years of ag e in the former and from age 14 in the latter. Microbiological confirmation of diagnosis was obtained in 254 (78%) cases, 52% in those aged 10-13 year s and 86% in those greater than or equal to 14 years. Pleural effusion was present in 42 (13%), 26 males and 16 females (p < 0.05). Thirteen (7%) of t he 182 hospitalized adolescents and 27 (19%) of the ambulant group did not complete therapy. The nature of tuberculous disease in adolescents changed dramatically with increasing age.