Children on Tuberculosis

Posted by galleca on May 22, 2009

According to Wikipedia, tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and often deadly infectious disease caused by mycobacteria, in humans mainly Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal system, bones, joints, and even the skin. Other mycobacteria such as Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, and Mycobacterium microti also cause tuberculosis, but these species are less common in humans.

When someone with untreated TB coughs or sneezes, the air is filled with droplets containing the bacteria. Inhaling these infected droplets is the usual way a person gets TB.

One of the most dreaded diseases of the 19th century, TB was the eighth leading cause of death in children 1 to 4 years of age during the 1920s. As the general standard of living and medical care improved in the United States, the incidence of TB decreased. By the 1960s, it wasn’t even in the top 10 causes of death among children of any age group.

But TB is making a comeback in the United States today — particularly among the homeless, those in prison, and those rendered susceptible because of HIV infection.

Signs and Symptoms

In older infants and children, primary pulmonary tuberculosis (the first infection with the tuberculosis bacteria) usually produces no signs or symptoms, and a chest X-ray shows no signs of infection. Rarely, there may be enlargement of the lymph nodes and possibly some coughing.

In most cases, only a tuberculin skin test (used to figure out if someone has been infected by the tuberculosis bacteria) is positive, indicating that the child has been infected. Children with a positive tuberculin test, even if they show no disease, will usually need to receive medication.

This primary infection usually resolves on its own as a child develops immunity over a 6- to 10-week period. But in some cases, it can progress and spread all over the lungs (called progressive tuberculosis) or to other organs. This causes signs and symptoms such as fever, weight loss, fatigue, loss of appetite, and cough.

Another type of infection is called reactivation tuberculosis. Here, the primary infection has resolved, but the bacteria are dormant, or hibernating. When conditions become favorable (for instance, a lowered immunity), the bacteria become active. Tuberculosis in older kids and adults may be of this type. The most prominent symptom is a persistent fever, with sweating during the night. Fatigue and weight loss may follow. If the disease progresses and cavities form in the lungs, the person may experience coughing and the production of saliva, mucus, or phlegm that may contain blood.

Treatment

A doctor may recommend hospitalization for the initial evaluation and treatment of TB, especially if:

* the child is a young infant
* there are severe drug reactions
* there are other diseases along with TB

However, most kids with tuberculosis can be treated as outpatients and cared for at home. The treatment is usually in the form of oral medications. In some cases, three or four drugs may be prescribed. Even though treatment may require months to complete, it’s vitally important that the full course of medications be taken in order for tuberculosis to be cured.

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