MILIARY TUBERCULOSIS IN CHILDREN

Abstract

Objective: To study the clinical presentation and laboratory findings in childrensuffering from miliary tuberculosis.Design: Observational studyPlace and Duration of Study: Pediatrics Department, Bahawal VictoriaHospital, Bahawalpur from June 2007 to December 2008.Subjects and methods: Children admitted with miliary tuberculosis.Results: Sixty-two cases were diagnosed over one and half year’s period. Out ofthese 17.74% cases did not complete the follow up (9.68% due to the death and 8.06 not returning back to the health facility) while the rest improved.Girls were 43.55% while children below I y of age were 19.35%. Only 14.52% cases were BCG vaccinated. There was history of contact in family in 32.26% cases. The duration of symptoms was more than one month in 14.51% cases. The common symptoms / signs include fever (93.55%), loss of appetite (72.58%), cough (59.68%), fatigue (43.55%), loss of weight (32.26%), vomiting (20.97%), irritability (20.97%), respiratory distress (17.74%), diarrhea (14.52%), deterioration of consciousness (12.91%), headache (12.91%), convulsion (6.45%) and night sweat (6.45%). There was history of immune suppression in 11.29% cases. The most common sign elicited was hepatomegaly, present in 87.1% cases, followed by lymphadenopathy in 29.03%; signs of meningeal irritation were present in 14.52%. Most common abnormality in laboratory reports were raised ESR in 83.87% and anemia in 85.48%.Conclusion: Miliary tuberculosis has nonspecific clinical features.