Bacteriological Evaluation for Diagnosis of Tuberculosis in Children


1 Department of Pediatrics,

2 Chronic Respiratory Disease Research Center, NRITLD, Shahid Beheshti University, M.C., TEHRAN-IRAN.

3 Department of Pediatrics


Background: During the last decade of the 20th century, the number of new cases of tuberculosis (TB) in children increased worldwide. Pulmonary TB in adults is diagnosed by isolation of Mycobacterium tuberculosis .In children; the diagnosis is based on diagnostic criteria and characteristics of the disease. The aim of this study was to evaluate bacteriological specimens from children with TB hospitalized in the pediatric tuberculosis ward of Masih Daneshvari Hospital.We assessed the results of smears, cultures and polymerase chain reaction (PCR) of gastric aspirates for confirmation of clinical findings. Materials and Methods: A descriptive study was performed on126 medical records of children with TB during a 5-year period. Demographic data including age and gender, pulmonary and extra-pulmonary TB presentations and gastric washing smear, culture and PCR were collected and then analyzed by SPSS software. Results: The study patients were divided into three groups of age: 0-5 yrs, 6-10 yrs and 11-15 yrs. The highest frequency (68.3%) was observed in the 11-15 years age group; 47.6% of the patients were males and 52.4% were females. The tuberculin skin test was positive in 73% of patients. Gastric aspirate smears, culture and PCR were positive for Mycobacterium tuberculosis in 55.6%, 58.7% and 53.2% of cases, respectively. Computed tomography (CT) scan showed evidence of TB in 94.4% of patients. In 34 patients, chest x-ray was normal and TB was diagnosed via CT-scan of the lung. Conclusion: The present study suggests that gastric lavage smears and cultures have high diagnostic value in TB diagnosis in children. In addition, chest CT-scan is recommended for diagnosis of TB in suspected children when other evaluations are normal. (Tanaffos 2009; 8(2): 42-45)