Pulmonary Tuberculosis

Abstract

Tuberculosis has been present throughout the history of mankind and is still the most common disease in the world, causing 2 million deaths per year. Tuberculosis is caused by Mycobacterium tuberculosis, mostly transmitted through the airway from contagious adults. Tuberculosis diagnosis in children is still a major challenge because bacteriology has a low yield. It is classified as (a) pulmonary presentation: primary complex (most common one), progressive pulmonary compromise, adult type of tuberculosis; (b) extrapulmonary presentation: pleural tuberculosis, adenitis; and (c) disseminated presentation: military, connatal, and meningitis tuberculosis. Tuberculosis is suspected in children exposed to an identified patient, those with an unresolved pneumonia, or with compatible clinical findings of adult-type presentation. The diagnosis approach begins with chest X-ray, PPD (protein purified derivatiive), and bacteriology. Treatment is based on the use of associated drugs for an extended and supervised period of time. Antibacterial combination therapies are based on the estimation of bacillus load and elimination rate.