Aboriginal Studies

Abstract

Background: adolescents comprise one-third of pediatric tuberculosis (tB) cases in the united states, but there are few specific data on the epidemiology and clinical course in this population. Methods: this was a retrospective review of adolescents (12-18 years old) seen at a Children's tuberculosis Clinic in Houston, tX, from 1987 to 2012. Results: One hundred forty-five adolescents were identified; median age was 15.4 years: 50% female, 55% were Hispanic, 26% black, 13% asian and 1% white; 54 were born abroad. diagnoses were made after symptomatic presentation in 79%, during contact investigations in 14% and after screening tuberculin skin testing in the remainder. the most common symptoms were fever (63%), cough (60%) and weight loss (30%), but 21% were asymptomatic at diagnosis. Only 8% of adolescents with intrathoracic tB had hemoptysis. One hundred fourteen (78.6%) had isolated intratho-racic tB, 4 (2.8%) had intra-and extrathoracic tB and 27 (18.6%) had extrathoracic tB. the most common sites of extrathoracic tB were peripheral lymphadenopathy (10) and meningitis (6). the most common radio-graphic findings were infiltrates (34%), lymphadenopathy (27%), cavitary lesions (26%), pleural effusions (19%) and miliary disease (10%). acid-fast bacillus smears and mycobacterial cultures were attempted for 97 of 118 adolescents with intrathoracic and 22 of 27 with extrathoracic disease, respectively, resulting in smear/culture positivity in 25% and 54% and 18% and 45%, respectively. two patients died, 2 had relapse, 7 had significant sequelae and 92% recovered without complication. seventy three percent of cases potentially were preventable. Conclusions: the clinical, radiologic and microbiologic findings in adolescents with tB have features seen in both younger children and adults; most cases were preventable.