%0 Journal Article
%T Classic and New Diagnostic Approaches to Childhood Tuberculosis
%A Gladys Guadalupe L車pez 芍valos
%A Ernesto Prado Montes de Oca
%J Journal of Tropical Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/818219
%X Tuberculosis in childhood differs from the adult clinical form and even has been suggested that it is a different disease due to its differential signs. However, prevention, diagnostics, and therapeutic efforts have been biased toward adult clinical care. Sensibility and specificity of new diagnostic approaches as GeneXpert, electronic nose (E-nose), infrared spectroscopy, accelerated mycobacterial growth induced by magnetism, and flow lateral devices in children populations are needed. Adequate and timely assessment of tuberculosis infection in childhood could diminish epidemiological burden because underdiagnosed pediatric patients can evolve to an active state and have the potential to disseminate the etiological agent Mycobacterium tuberculosis, notably increasing this worldwide public health problem. 1. Introduction Tuberculosis is the leading cause of death worldwide, with over 1.5 million deaths per year. This disease is caused by Mycobacterium tuberculosis, which is an acid-fast bacilli, and it is transmitted mainly by the airway [1]. While adult TB cases are often easily recognizable, due to typical symptoms (radiological features and a positive sputum smear), TB in childhood is frequently more difficult to diagnose due to the atypical radiological features and the difficulty to expectorate [2]. Furthermore, there is a significant morbidity and mortality in children worldwide [3], with a majority of cases of latent TB infection (LTBI) and active disease occurring in developing countries [4]. Childhood tuberculosis is commonly extrapulmonary, disseminated, and severe, especially in children under 3 years of age, and it is associated with high morbidity and mortality [5]. Approximately, 15每20% of all TB cases in sub-Saharan Africa are in children [6]. The natural history of TB in children and pediatric patients follows a series of steps. Phase 1 occurred 3每8 weeks after primary infection. This is the end of incubation period and the initiation of well-defined signs: fever, erythema nodosum, a positive tuberculin skin test response, and formation of the primary complex visible on chest radiography. Phase 2 occurred 1每3 months after the phase 1. In this period, the bacillus can migrate to other parts of the body via the blood and represented the period of the highest risk for the development of tuberculous meningitis and miliary tuberculosis in young children. This is the phase where dissemination of the bacillus most frequently occurs. Phase 3 occurred 3每7 months after primary infection. This is the period of pleural effusions in >5 years old
%U http://www.hindawi.com/journals/jtm/2012/818219/