1Dipartimento Materno-Infantile, 2Laboratorio Regionale di Riferimento per la Diagnostica delle Infezioni da Micobatteri, Dipartimento dei Servizi Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona
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Key words: Tuberculosis, Diagnosis, Morbidity, Mortality, Children, Cases report
Tuberculosis is a major cause of morbidity and mortality worldwide. In the last twenty years, changed social conditions due to immigration have largely modified the epidemiology of tuberculosis in western countries. Children with tuberculosis are markers of recent disease transmission, usually from infectious adults. In the majority of cases, they are not infective and therefore do not transmit the disease. However, they are an important link for epidemiological purposes. Symptoms of tuberculosis are characteristically nonspecific in childhood. The diagnosis is challenging and is easy to miss. A thorough history and a complete physical examination should not be neglected. Laboratory, microbiologic and radiologic findings may strongly support the diagnosis and specific investigations should be carried out, if tuberculosis is suspected. In the present article, different cases of pulmonary (progressive primary disease, postprimary disease) and extrapulmonary (pleural, abdominal, osteoarticular, meningitis) tuberculosis observed in an Italian third-level paediatric hospital are described. Diagnostic dilemmas and therapeutic problems that paediatricians may encounter during their professional activity are discussed.
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