Tuberculosis (Pediatric TB)
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## 🫁 **Tuberculosis (Pediatric TB)**
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### ❓ **What is TB?**
**Tuberculosis (TB)** is a **bacterial infection** caused by *Mycobacterium tuberculosis*.
It mainly affects the **lungs**, but can spread to **other parts of the body**.
In **children**, TB is often **harder to detect**, and they are more at risk of severe disease.
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### 👶 **Why Pediatric TB is Different**
- Children have **immature immune systems**
- TB may progress **faster and more severely** (e.g., TB meningitis, miliary TB)
- Diagnosis is more **challenging** (sputum often not available)
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### 🦠 **Types of Pediatric TB**
1. **Pulmonary TB** – Lungs affected (most common)
2. **Extrapulmonary TB** – TB outside the lungs:
- TB meningitis
- TB lymphadenitis (swollen lymph nodes)
- Bone/joint TB
- Miliary TB (spread throughout the body)
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### 🔍 **Causes & Risk Factors**
- Exposure to **infected adults** (usually in the same household)
- **HIV infection**
- Malnutrition
- Young age (esp. **<5 years**)
- Weakened immune system
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### ⚠️ **Symptoms of Pediatric TB**
**General:**
- Persistent **cough >2 weeks**
- **Fever** (esp. evening)
- **Weight loss or failure to thrive**
- Night sweats
- Fatigue, reduced playfulness
**Pulmonary TB:**
- Cough with or without sputum
- Chest pain
- Breathing difficulty
**Extrapulmonary TB:**
- Swollen lymph nodes (usually painless)
- Headache, vomiting (if TB meningitis)
- Bone/joint pain or swelling
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### 🧪 **Diagnosis**
- **History of contact** with TB-positive person
- **Tuberculin Skin Test (TST)** or **Mantoux test**
- **Chest X-ray**
- **GeneXpert MTB/RIF test** (molecular test)
- **Sputum test** (if the child can produce it)
- **Gastric aspirate**, **bronchoalveolar lavage** (for younger children)
- **Blood tests** and **CSF** (for TB meningitis)
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### 💊 **Treatment (DOTS Therapy)**
- Standard **6-month anti-TB treatment**:
1. **Intensive phase** (2 months):
Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), ± Ethambutol (E)
2. **Continuation phase** (4 months):
Isoniazid + Rifampicin
- **DOTS** = Directly Observed Treatment, Short-course
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### 📌 **Prevention**
- **BCG vaccine** at birth
- Screen and treat **close contacts**
- Good ventilation and hygiene
- Nutritional support
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### ⚠️ **Complications (if untreated)**
- TB meningitis (can cause brain damage or death)
- Miliary TB (widespread, life-threatening)
- Lung damage or scarring
- Bone/joint deformities
- Growth delay
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### 🛡️ **Prognosis**
- **Good** with **early diagnosis and full treatment**
- Untreated TB can be **fatal** or lead to **long-term disability**
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