Clinical Spectrum of Pediatric Tuberculosis: A Microbiological Correlation from a Tertiary Care Center Neha Gupta, 1 Bineeta Kashyap, 1 Pooja Dewan, 2 Puneeta Hyanki, 3 and N. P. Singh 1 1 Department of microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi 110095, India 2 Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi 110095, India 3 CMO I/C DOTS Center, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi 110095, India Correspondence: Bineeta Kashyap, Flat no. C-402, Vimal CGHS LTD., Plot-3, Sector-12, Dwarka, New Delhi-78, Delhi, India. E-mail <dr_bineetakashyap@yahoo.co.in>. ABSTRACT Aim and objectives: The paucibacillary nature of pediatric tuberculosis (TB) makes diagnosis diffi- cult. The aim of the study was to correlate the clinical spectrum of pediatric TB with microbiological diagnosis. Materials and methods: Specimens from clinically suspected pediatric TB cases were subjected to Ziehl–Neelsen staining, culture on Lowenstein–Jensen medium and cartridge-based nucleic acid amplification test (CB-NAAT) for TB. Results: Pulmonary TB was the predominant form affecting 36 of 62 (58%) patients. Tubercular meningitis was the commonest form of extrapulmonary type and affected 13 of 26 (50%) children. Microbiological diagnosis by any of the above methods could be established in 35 (56.45%) cases. While 33 of 36 (92%) patients diagnosed with pulmonary TB had radiological findings, of which only 25 (76%) could be microbiologically confirmed, only 24 of 31 (77%) patients with extrapulmo- nary symptoms had radiological evidence and microbiological confirmation could be achieved in 4 (17%) of these. Conclusion: An integrated approach of diagnosis, including clinical–radiological, microbiological and immunological evidence should be stressed on. KEYWORDS : pediatric, tuberculosis, clinical, radiological, microbiological, CB-NAAT INTRODUCTION Tuberculosis (TB) is one of the major public health problems globally [1, 2]. The total number of new cases of TB worldwide in 2015 was 10.4 million out of whom 10% were pediatric. Total 60% of the bur- den was attributed to six countries, India being one of them [1]. India bears the highest burden of TB and multi drug resistant (MDR) TB. In 2015, inci- dence of TB and childhood TB cases notified in India was 2.8 million and 2 55 000, respectively [1]. Childhood TB accounts for 10–20% of TB and asso- ciated mortality in high-burden countries [3]. High case density and delayed diagnosis in endemic areas lead to high infection rates in pediatric population. Childhood TB is a measure of ongoing transmission and control of adult TB [4]. Children are more likely to progress from expos- ure to disease as compared with adults because of V C The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com  130 Journal of Tropical Pediatrics, 2019, 65, 130–138 doi: 10.1093/tropej/fmy026 Advance Access Publication Date: 28 May 2018 Original paper Downloaded from https://academic.oup.com/tropej/article/65/2/130/5017424 by guest on 24 February 2022