How to recognize and treat tuberculosis in children, its types and prevention. Tuberculosis bacillus in children - the first signs in the early stages Does a child have tuberculosis

The disease that came to us from the depths of centuries every year harms a huge number of people of different social and financial status. One of the serious infectious diseases can harm both infants and gray-haired old people. Tuberculosis can affect the vital organs of a person. The insidiousness of the disease is that it can proceed in a latent phase for several years. What are the early symptoms of TB in children? What should alert caring parents so as not to miss the onset of the disease? Children have their own characteristics of the course of the disease, which every parent should know.

What is fraught with tuberculosis, what is its deceit?

An airborne infectious disease is dangerous because it can affect all systems and vital organs, but the causative agent of tuberculosis gives the greatest preference to the lungs of a person. The disease in ancient times was called consumption from the word "waste", in which the patient's body was severely depleted, cough and weakness were the main companions of this disease. In 1882, Robert Koch discovered the causative agent of this contagious disease.

All these qualities contribute to easy infection and very problematic and lengthy treatment. But this pathogen does not tolerate sunlight and dies under its direct influence in a few minutes. It is encouraging that not every person who has entered the body of the virus will necessarily get sick. The insidiousness of this disease lies in the fact that only under favorable conditions, the infection that has been hiding in the body for years can begin its destructive effect. And if you look at the first symptoms of tuberculosis in children, then there is a risk of the infection spreading not only to the lungs, but also to other organs.

Sources of infection and method of entry into the body

Tuberculosis can be contracted from a sick animal or person who, when coughing or expectorating sputum, secretes MBT (tuberculosis microbacterium).

According to statistics, a patient with an open pulmonary form of tuberculosis infects up to 20 people a year. The child may become infected:
. Through the street dust Tuberculosis bacilli rise into the air in windy weather and penetrate into the lungs of a child with the flow of inhaled air.
. In 95% of cases - by airborne droplets. This is possible when staying with a patient with tuberculosis in the same room and inhaling contaminated air, as well as on the street, because when coughing, infectious bacteria spread at a distance of up to two meters, and up to 9 meters when sneezing.
. Through the lacrimal sacs, the conjunctiva of the eyes and even the skin when rubbing with fists on which the infectious bacillus is located.
. Through the esophagus, when the products of sick animals (milk and meat) are consumed.

The main thing in this case is not to ignore the first symptom of tuberculosis in children and to sound the alarm in time when they suspected something was wrong with the child.

Vulnerability of the child's body

There is a widespread belief that people who are malnourished, live in unsanitary conditions in rooms with a high level of dampness, and also, by the nature of their activities, often have to come into contact with people infected with tuberculosis, get sick with tuberculosis. These factors are relevant for both children and adults. But for a number of reasons, children are at risk of becoming infected much more often, and this is due to age-related characteristics that affect the structure of some organs. The instability of the child's immune system to aggressive tuberculosis infection also plays a decisive role.

The course of the disease in the smallest is characterized by a number of features. For infants, the disease is especially dangerous, because it easily passes into the active stage, causing serious consequences.

It is easy to see the symptoms of tuberculosis in children under one year old, it can be confused with the common cold, without paying serious attention to the manifestations of the disease due to the characteristic features of age:
. vulnerable immune system, when phagocytes are not able to cope and destroy the infection that has entered the body;
. underdeveloped lung ventilation function;
. with a poorly expressed cough reflex;
. due to the small number of mucous glands, the dry surface of the bronchi contributes to the penetration of tubercle bacillus into the lungs.

First manifestations

What are the symptoms of tuberculosis in children? Penetrating into the child's body easily, the disease is masked and difficult to treat. The disease can be confused with the common cold. The determining organ is the one that affects the infection. The symptoms of the disease also depend on the dysfunction of the affected organ or system, as well as on the activity of the course. The “blurring” of the manifestation of the disease can do a disservice.

Although it is easier to identify tuberculosis in early childhood than at 8 years of age and adolescence, when the symptoms are less pronounced.

The absence of complaints due to their infancy will complicate the diagnosis of the disease in babies, so you should rely only on the attentive attitude of parents to the health of the child.

Symptoms of tuberculosis in children 3 years old are as follows:
. disorders of the nervous system, expressed in general intoxication of the body;
. the baby becomes nervous and tearful for no reason, anxiety is pronounced;
. sleep disturbance;
. increased sweating during sleep (palms, back and pillow are always wet);
. lack of appetite;
. violation of the digestive function;
. unreasonable temperature fluctuations: a slight increase in body temperature in the evening up to 37-37.5 ° C and a drop to 36 ° C in the morning, which is of a protracted nature;
. the cough has a bitonic character (in a double tone: low and additionally high);
. the lymph nodes are enlarged, but do not cause pain, and the lymph nodes at the pulmonary roots initially react, then over the collarbones and neck.

Complications

Tuberculosis in infants also has a peculiarity, the symptoms should alert the mother when feeding, when ideal feeding ends with dyspeptic disorders: dysfunction of the gastrointestinal tract, regurgitation.

This is an incomplete list of complications that an infection can cause in children under three years of age.

Pulmonary tuberculosis: symptoms in children. How to avoid infection?

The initial manifestations of the disease are mild, and very often they are ignored. Parents should definitely pay attention to drowsiness, fatigue, lethargy of their child. Children 7-8 years old and adolescents, having become infected with tuberculosis, may have signs of bronchitis or a common viral infection, under which tuberculosis is disguised. Sometimes the classic symptoms of this disease appear suddenly. Parents should pay attention to lurking tuberculosis. Symptoms, the first signs in children are manifested as follows:
. a slight increase in temperature to 37 with a small degree, which does not subside for a long time;
. shortness of breath that gets worse over time
. chills at normal ambient temperature;
. profuse sweating at night;
. weakness, loss of strength;
. persistent cough that does not go away for several weeks;
. lack of appetite;
. sputum is expectorated, and sometimes with blood;
. weight loss for no apparent reason;
. pain in the chest.

You should not ignore any symptom of tuberculosis in children, so as not to miss precious time to take adequate measures in this situation.

Pulmonary tuberculosis in children is curable, so you should not panic. It is urgent to contact a phthisiatrician, who will prescribe the appropriate treatment. The path to recovery will be long, but this disease, with timely seeking medical help, is quite curable. With the advanced form, the disintegration of lung tissues and the spread of focal infection to other organs are possible.

Symptoms of bone tuberculosis in children

In the understanding of most people, when mentioning the diagnosis of tuberculosis, associations immediately arise with the pulmonary form of the disease. It should be noted that this infection affects not only the lungs, but also other human systems and organs, including bones and joints.

With damage to the joints and bones, the disease proceeds very slowly. Parents should pay serious attention to children's complaints about pain during movement, because a symptom of tuberculosis in children, at the initial stage of damage to the spine and joints, is pain during any physical activity that haunts him. And with the development of the disease, the child is threatened with lameness and a dramatic change in gait.

The patient will have to live with the following painful manifestations:
. fragility of bones, resulting in frequent fractures;
. stiffness in movements due to pain at the slightest physical activity;
. severe pain in the spine and all joints;
. there is a deformation of the bone or joint, the affected area swells.

In order not to lead to irreversible consequences of bone tuberculosis, symptoms, the first signs in children should alert parents. Adults are obliged to show the child to medical specialists. This will prevent the transition of the disease to the postarticular phase, save the child's life and save him from disability.

Necessary procedures to confirm / refute the diagnosis

If tuberculosis is suspected, children are prescribed the necessary tests (general and detailed analysis of urine and blood), x-rays of the lungs are prescribed, morning sputum is taken for two days in a row. Based on these analyzes, the TB doctor makes a conclusion. If necessary, additional tests are prescribed to have a complete picture. A test is also performed to detect the sensitivity of a child's body to a tubercle bacillus - the Mantoux test. Very often, this test reveals the presence of an infectious bacillus in the body, but this does not mean that the child is sick with this disease. Often, the disease "waits" for a convenient moment, so that under favorable conditions (stressful situation or a cold) to begin active development. That's when it is necessary not to miss the first symptom of tuberculosis in children.

What should be done when a disease is detected?

Even at the slightest suspicion of tuberculosis, parents should urgently contact a pediatrician. Adequate treatment at the initial stage is crucial. It is strictly forbidden to start treatment on your own, and even more so to use antibiotics, to which the tubercle bacillus easily adapts. As a result, the risk of developing complications in the child will increase, which will add problems during treatment. You will have to take anti-tuberculosis drugs for a long time, and they seriously affect the entire child's body, not only the tubercle bacillus.

To identify an ailment such as tuberculosis in children, symptoms and treatment should be carefully evaluated by a medical specialist.

Therapy

Drugs are prescribed based on the examination of the child. The dosage is calculated taking into account the physiological characteristics of the body and the weight of the patient. Mild illness does not always require hospitalization. The prescribed drugs "Streptomycin" or "Isonoazid" are issued free of charge by the attending phthisiatrician for the entire necessary course of treatment. Take the drug along with dairy products to minimize its effect on the walls and gastric mucosa.
If timely treatment is prescribed, then a positive effect occurs quickly due to the unique ability of the child's body to quickly regenerate damaged tissues.

Prevention of the development of tuberculosis in children

It is easier to protect yourself than to get rid of the disease. Preventive measures can prevent and save the children's body at such a tender age from health problems.

How to protect a child from a disease such as tuberculosis? In children, the symptoms (photo) manifest themselves in different ways, which means that you need to be attentive to any cold, to track the most minor deviations in behavior and health.

The list of preventive measures includes:
1. A complete balanced diet.
2. Minimization of stressful situations.
3. Normal sleep and daily routine.
4. Mandatory vaccination, as well as BCG revaccination, strictly following the developed vaccination schedule.
5. To determine immunity to a tubercle bacillus, the body is tested by the Mantoux reaction annually until the age of 18 for vaccinated children, and twice a year for unvaccinated children.
6. For children in contact with patients with tuberculosis, chemoprophylactic treatment with special preparations is provided.

All these measures will help strengthen the immunity of the child, thereby preventing the development of the disease. But even if tuberculosis is detected, you should not despair, because in our time you can get rid of this disease. It is important to start treatment on time, then the result will be positive.

Tuberculosis is a disease that is transmitted mainly by airborne droplets. Its causative agent is Koch's wand. Tuberculosis can be called a social disease, because 80% of patients have a fairly low standard of living.

In the modern world, it is not at all necessary to live on the street in order to get TB, everyone is at risk - both a child and an adult.

Tuberculosis in children is more severe than in adults. This is due to the fact that children are much more susceptible and weaker. It is about childhood tuberculosis that we will talk about today. Let's find out what pulmonary tuberculosis is in children, how it develops and how it is treated.

Factors of infection and development of the disease

It is quite easy for a child to become infected with tuberculosis. The main route of infection is contact with the sputum of a sick person with an open form of the disease. Coughing, the patient sprays particles of sputum around him, which falls on the people around him, settles on the floor and furniture.

A child can become infected by inhaling contaminated air, by contact with contaminated things, by consuming infected products. Most often, the stick enters the child's body through the oral cavity, but in rare cases, a transplacental route of infection is also possible.

The mother of the child must be extremely careful, follow all the recommendations of the doctor, and then the child has every chance to grow up completely healthy. Thus, the causes of tuberculosis in children are few - usually it is an elementary disregard for hygiene or contact with an infected person.

Stages of the disease in children

Once in the body, Koch's wand affects the cells of the immune defense, and then the tissues of the body. T-lymphocytes also begin to work actively, but they are weak and quickly die.

As a result, it is the fault of T-lymphocytes that causes the formation of necrotic tissues, which are an excellent environment for the development of the disease.

Cells pass through the capillaries, which help to form tuberculous granulomas, expanding the focus of inflammation more and more. Affected tissues die.

The body reacts to MBT with tuberculous inflammation caused by three components:

• exudative;
• proliferative;
• damaging.

Each of these components is characterized by an individual process. During exudation, cellular components come out of the vessels, during proliferation they grow, and at the stage of destruction, cheesy necrosis is formed. These processes occur regardless of the form and localization of the disease. Below we will consider the phases of tuberculosis in more detail.

Phases of tuberculosis during primary infection

Infection at first practically does not manifest itself in any way. Clinically, the signs are either very poor or non-existent. During this period, pathogens enter the lymphatic system and organs of immunogenesis. It was at this time that the reaction to Mantoux becomes positive.

This is followed by a pre-allergic period (lasting 2 weeks), during which antibodies are formed. Despite the presence of Koch's bacillus in the body, Mantoux is often negative.

The allergic period is characterized by the fixation of infection on the organs of immunogenesis (these include the spleen, bone marrow, liver, lymph nodes). Lymphocytes accumulate around the MBT. There are no signs of intoxication yet, there is no damaging component, but the lymph nodes are already enlarged.

With proliferation, the number of lymphocytes around the MBT increases. They prevent the growth of the destructive process. The higher the immunity, the greater the number of lymphocytes "protects" the infection. After six months, the destruction of surrounding tissues begins and a caseous-necrotic (destructive) component occurs. Intoxication is still poorly expressed.

1 year after infection, mini-necrosis is observed with mini-proliferation (growth of surrounding tissues), which is caused by each of the rods that have entered the body.

Intoxication is expressed, Mantoux is positive. Local forms of tuberculosis appear in children, as well as adolescents, which can be prevented by treatment. A sick child should visit a pediatric phthisiatrician.

If tuberculosis in a child subsides, on his organs (lungs, bronchi, intestines, bones, lymph nodes), where inflammation was previously localized, points of caseous necrosis remain, which at an older age can cause newly developed tuberculosis. This trend is observed in 90% of cases.

Due to external factors that reduce the strength of immunity, it begins to react to the presence of mycobacteria in the body, sending certain families of lymphocytes there, namely macrophages. They begin to absorb harmful bacteria, but die, releasing special enzymes.

The latter liquefy the caseous tissue. With pulmonary tuberculosis, mycobacteria are secreted into tissues, and then into the surrounding space, and the patient becomes pathologically dangerous to other people.

Regression of the disease

The healing process occurs after treatment or without it, if the sick child has a strong enough immune system. In this case, the decay cavities begin to decrease and close, being replaced by scars. The process subsides, and the infection stops its development (usually this happens at 3, 4 and 5 years).

During the fight against MBT, lymphocytes begin to damage healthy tissues. In response, the body produces antipreases.

This process can be balanced, but if the immune system fails, then the cirrhotic form of pulmonary tuberculosis begins.

Primary and reinfection

Like an adult, childhood tuberculosis can take many forms, depending on how many times it develops in a child. Each of the forms has its own subspecies, but not all of them develop in children or develop quite rarely. Therefore, we confine ourselves to describing the most common types of each form of tuberculosis in children and adolescents.

General symptoms

For the first 1-2 weeks, the symptoms of an acute illness resemble those of a cold. If after 3 weeks they do not go away, there is a risk of developing the disease. For the first 3 weeks, children suffer from a dry cough, and why does a wet cough begin with pinkish discharge.

Among the main signs of tuberculosis in children are:

Other symptoms that can be confused with other diseases include:

• with damage to the meninges, convulsions, headaches, vomiting are observed;
• intestinal tuberculosis is manifested by indigestion, vomiting, blood in the stool;
• tuberculosis of the bones and joints causes pain in a state of movement, increases the risk of fractures and lameness;
• tuberculosis of the genitourinary system reports itself with back pain, high fever, pain during urination and blood in the urine;
• the skin affected by the infection is thickened, the lymph nodes enlarge and rot, tearing the membrane.

How are the forms of the disease manifested in children?

Pulmonary tuberculosis in children of the primary form occurs in the vast majority of those infected, in contrast to the secondary, the occurrence of which in children is quite rare. For children under 2-4 years of age, pulmonary tuberculosis is especially dangerous and is much more difficult to tolerate than in adults.

In the period up to 4-7 years, the tendency to extensive infection is especially pronounced, since the effect of BCG vaccination is weakening by this time, so complications are often observed. Nevertheless, even in such conditions, with primary tuberculosis, there is a high chance of a reduction or complete disappearance of the focus.

Tuberculosis of the intrathoracic lymph nodes refers to the primary infection. It is diagnosed in 80% of children with this disease. Specific changes are little expressed, therapy gives a positive trend. Tumorous (tumor-like) form has a more severe course and is more common in young children (up to 4-6 years).

Secondary tuberculosis is diagnosed in adolescents not so often, as a rule, these are young people who had primary infection in childhood. It usually coincides with puberty and is diagnosed at 13-14 years of age. Symptoms coincide with the primary genesis. Infiltrative and focal pulmonary tuberculosis predominates.

Disseminated tuberculosis is rare in children and adolescents. It is preceded by primary infection with a breakthrough of the focus into the blood with sensitivity of the vascular system. The main reason for the appearance of this form is an endogenous decrease in immunity.

In early adolescence, the infection often occurs in the form of miliary tuberculosis - this is the defeat of other organs along with the lungs.

The subacute form develops against the background of the subsidence of the primary infection, but sometimes it also manifests itself as a secondary form.

The chronic form of disseminated tuberculosis acquires fibrotic-tricky features, with seasonal exacerbations. Its outcome is usually unfavorable. Tuberculous pleurisy, which also sometimes occurs as a complication of secondary tuberculosis in a teenager, may be a complication of tuberculosis of the intrathoracic lymph nodes or a separate disease.

Separately, it should be said about extrapulmonary tuberculosis. Studies have shown that over the past 15 years, the percentage of extrapulmonary forms of the disease has decreased. In young children (from 1 to 5-7 years old), tuberculitis meningitis and tuberculosis of the central nervous system are most often diagnosed, and in adolescents, tuberculosis of the peripheral lymph nodes and the genitourinary system.

Treatment and prevention

Are vaccinated children at risk of infection? This vaccination does not protect the child from infection, but it significantly reduces this risk and does not allow the disease to move from a closed form to an open one, and also helps to avoid serious complications in case of infection.

The weakened virus vaccine allows the body to develop immunity without infecting the child. Many doctors recommend vaccinating children, despite the presence of preservatives in the vaccine.

Treatment of tuberculosis in children and adolescents is of two types:

How to treat a child if infection with tuberculosis is present, the doctor should advise. It has been noticed that children who started treatment in a timely and correct manner often recover, as their tissue regeneration is faster.

The consequences of tuberculosis, if it was detected in the later stages, are very severe and can lead to serious complications and even death. The consequences of treatment for tuberculosis, sometimes lasting two or three years, can be both positive and negative. Chemotherapy in 15% of cases causes a side effect - toxic or allergic. Often, children who are at risk suffer from it - with chronic diseases, overweight, and a tendency to allergies.

The peculiarity of tuberculosis in children, first of all, is its danger to health. As mentioned above, in children under 5 years old, the tubercle bacillus causes more complications than in older children. However, in addition to age, factors such as poor nutrition, lack of vitamins, stress and lack of sleep play a large role in the development of the disease.

In conclusion, I would like to say that, despite the seriousness of this disease, there is always an opportunity to cure a child. The main thing is to constantly monitor his health, regularly check for tuberculosis, do not self-medicate and strictly follow the recommendations prescribed by the doctor.

Tuberculosis in children is one of the most common airborne diseases. According to statistics, the symptoms and signs of morbidity among children this year are several times higher than five years ago. The risk group includes kids from dysfunctional families, with low immunity or poor living conditions.

But, unfortunately, these data do not say at all that in well-off families where there are no infected patients, you suddenly will not find symptoms of tuberculosis in a child.

Causes and ways of infection

Tuberculosis is caused by specific bacteria, Mycobacterium tuberculosis. The main route of transmission of the infection is airborne, but other routes of infection are possible: contact, alimentary (food), most rarely vertical (from mother to child). Of particular importance in MBT infection of children is direct long-term contact with TB-sick relatives (parents, grandparents, aunts, uncles, etc.).

When sneezing or coughing, the infected parent sprays sputum, which, settling on a dusty floor, begins to pose a real threat. Symptoms of the disease in the early stages can also occur due to the usual crawling on the floor and touching the dust contaminated with microbes with your hands. Then the baby puts his hands in his mouth or takes food with them. Failure to comply with elementary hygiene rules when in contact with the patient's things also provokes the onset of pulmonary tuberculosis in a child.

After the penetration of mycobacteria into the body, there may be 3 options for the development of the disease:

• The bacterium will completely disappear,
• Primary disease may develop (with rapid growth of mycobacteria),
• Mycobacterium can be in the body in a "sleep" mode, and with a decrease in general immunity or other "favorable" conditions, the bacterium will begin to multiply and symptoms of tuberculosis will appear.

The first thing to remember for every adult family member with tuberculosis is that you must be extremely careful, observing all the rules of hygiene, undergo treatment and be careful in communicating with the baby. A child with sick parents is recommended to be vaccinated.

In addition, try not to trust the upbringing of your child to strangers who have not passed a medical examination, avoid contact with bedding or clothing of a relative infected with pulmonary tuberculosis or intrathoracic lymph nodes, and do not offer your baby raw goat or cow milk. According to scientists, tuberculosis in children most often appears precisely through milk, which has not passed the analysis and is the main distributor of the bacterial bacillus.

Symptoms

There are several forms of tuberculosis of the respiratory organs, the most common being tuberculosis of the lungs and tuberculosis of the intrathoracic lymph nodes. Also, a lung lobe or only a segment may be affected, there may be an open form with bacterial excretion and a closed one (without isolation of mycobacteria). The disease can occur with or without complications. All this can only be determined by a TB doctor. However, what parents should pay attention to is main symptoms:

• cough for more than 2 weeks (dry/wet);
• sputum - mucous, mucopurulent / purulent with an admixture of blood (without blood), with an odor (odorless);
• hemoptysis;
• shortness of breath on exertion or at rest;
• chest pain (localization, nature, duration);
• increased body temperature (in the evening or at night);
• sweating (especially at night);
• weight loss;
• loss of appetite;
• adynamia, apathy;
• emotional lability - the child is either cheerful, or instantly sad, whiny;
• general weakness (especially pronounced in the morning);
• fast fatiguability;
• the child shows fatigue and irritability, if he attends school, he stops learning new material, begins to lag behind his peers.

Having noticed the first symptoms, parents should definitely pay attention to the lymph nodes. With tuberculosis, they, as a rule, increase, become painful.

If parents notice most of these symptoms, you should contact your pediatrician or phthisiatrician. It is also better to have vaccination data with you (it is done in the maternity hospital on the 3rd day of the baby's life) and data on Mantoux tests.

For a detailed examination, the doctor will prescribe blood and urine tests for the baby, sputum culture and, of course, a chest x-ray. It will also be necessary to put a Mantoux test and measure its value.

Diagnostics

In our country, due to the high incidence of tuberculosis, every child who has been vaccinated against tuberculosis, from 1 to 18 years old, undergoes immunodiagnostics, and at an older age - fluorography. In the event that for some reason vaccination is not carried out, the child must be examined 2 times a year, starting from 6 months.

After setting the Mantoux test after 72 hours, the reaction is measured, the results are recorded in the child's vaccination card. The data are evaluated by a doctor or a specially trained nurse.

In the event that a child has a positive Mantoux test for the first time or an infiltrate (blister) has formed at the site of the test or redness of more than 12 mm has been stable for several years, the child should be consulted by a phthisiatrician who will prescribe a more detailed examination.

The main contraindications for the Mantoux test are allergic diseases in the acute stage, acute diseases or quarantine for any disease. However, during the period of remission or after the removal of quarantine, the Mantoux test must be performed.

Blood tests by PCR and ELISA are currently not recommended for the detection of Mycobacterium tuberculosis. This study can detect not the mycobacterium itself, but only a fragment of its DNA, and only if there is a very high content of mycobacteria (in the foci of tuberculosis, or with a generalized form of tuberculosis).

Treatment of tuberculosis can be carried out in a hospital, sanatorium or on an outpatient basis. This is determined by the doctor. At the end of treatment, dispensary observation is carried out.

Prevention of tuberculosis in children - vaccination in the first days of his life. You should not refuse this event if you are offered it in the maternity hospital. According to statistics, vaccination in only 5% of newborns, subsequently gives the possibility of infection with tuberculosis of the lungs and intrathoracic lymph nodes. The vaccine is given three times - on the third, fifth and seventh day of life, which provides the baby with two years of protection against the disease. This vaccine is given only to healthy children.

Prevention of tuberculosis in children is only in the hands of parents. It is in their power to protect their child from infection with tuberculosis. Despite the vaccination, if the crumbs have a weakened immune system, avoid prolonged stay in places with large concentrations of strangers, protect contact with sick relatives and regularly diagnose tuberculosis in a child.

Parents should remember: the absence of clinical symptoms does not exclude the disease! In more than 50% of cases, tuberculosis in children is asymptomatic, so the main method for detecting tuberculosis infection (tuberculosis) in children is tuberculin diagnostics (immunodiagnostics), based on the detection of mycobacteria in the body.

Tuberculosis is considered one of the most serious and dangerous diseases. This disease often affects not only the lungs, but also other vital organs without any symptoms. Sometimes parents mistake signs of tuberculosis for manifestations of another disease - SARS or influenza.

First of all, the disease poses a danger to infants, since the diagnosis of tuberculosis in children entails many difficulties. Often, doctors treat simple bronchitis or a respiratory viral disease for months, starting tuberculosis at an early stage. The only sure way to protect yourself from the disease is to follow preventive measures and not refuse vaccination.

What is tuberculosis and what is its danger to a child?

Tuberculosis in children is an infectious and inflammatory process in the internal organs and tissues of the body, caused by the penetration of Mycobacterium tuberculosis. The infection spreads throughout the body, initially affecting the lungs and forming tuberculous tubercles in them.

Diagnosis and treatment of the disease largely depend on the age category of the patient. The disease is most critical for three ages - infants, infants under 3 years of age and adolescents.

This ailment is difficult to identify, its symptoms are very similar to the usual SARS. Parents therefore turn to a specialist not at an early stage, but when the infection has already settled in the baby's body. The only way to timely determine the disease is the regular observance of preventive measures.

With the timely detection of tuberculosis, the treatment of the baby will take no more than 2-3 months. Otherwise, the pathogenic process will last for months, moving from remission to an acute form.

Doctors distinguish three main groups of forms of tuberculosis:

• unspecified localization;
• respiratory tract;
• extrapulmonary injury.

Tuberculosis of unspecified location most often affects young children or adolescents. This form, as a rule, is found months and sometimes years after infection, so it often turns into chronic tuberculosis. The main methods of its diagnosis are a blood test or PCR.

Respiratory tuberculosis occurs in the most mild form and does not entail dangerous consequences. The incubation period lasts from several weeks to a year, until the moment of the first manifestations of the disease comes.

Extrapulmonary tuberculosis is a secondary disease that affects various internal organs of the child:

1. Tuberculosis of the meninges is a disease that is extremely life-threatening for a child. In a child's body, the disease is very difficult and entails many unpleasant consequences - a lag in mental and mental development, paralysis, convulsions. Children under one year old who have not been vaccinated with BCG are at the main risk zone. The first symptoms are accompanied by fever, body intoxication, headaches, convulsions. With timely diagnosis and effective therapy, tuberculous meningitis resolves in a few months.
2. Tuberculosis of the bones and joints affects the spine, as well as the hip and knee joints. The disease proceeds with clearly expressed symptoms - impaired movements and gait of the child, accompanied by pain.
3. Tuberculous kidney disease is a fairly common form of the disease in adolescents. Due to the primary infection of the lungs, the infection penetrates through the blood into neighboring organs and most often affects the kidneys.
4. Tuberculosis of the peripheral lymph nodes mainly occurs in children with HIV. The main symptom of the disease is an increase in lymph nodes. The child develops subcutaneous balls filled with pus.

How does the infection enter the body?

The initial manifestations of tuberculosis depend on how the bacillus got into the child's body. Parents should be aware of the ways of infection in order to prevent the occurrence of the disease in their baby.

The entry of mycobacteria is carried out in several ways:

• airborne, which is considered the most common when children are infected, since Koch's wand is transmitted when in the same room;
• airborne, when a child inhales dust particles containing a tubercle bacillus;
• through certain foods, for example, when eating meat or milk of sick animals;
• due to infection on the mucous membranes or damaged skin;
• transplacental way, that is, through the placenta of an infected mother.

The first and subsequent symptoms of various forms of the disease

In medicine, it is customary to distinguish between several varieties of tuberculosis of the respiratory organs, which are manifested by individual symptoms. The most famous type is tuberculosis of the intrathoracic lymph nodes. It occurs in children of any age. The infection affects the intrathoracic lymph nodes on one or both sides.

Accordingly, there are three forms:

• A small form of tuberculosis of the intrathoracic lymph nodes often occurs without any symptoms. In the body of a child, one or more lymph nodes slightly increase. The most effective diagnosis of this disease is carried out not only by X-ray of the lungs for the presence of tuberculosis, but also by computed tomography.
• The infiltrative form is most often seen in school-age children. With the help of a photo x-ray of the lungs, where a significant amount of fluid and dead areas are clearly visible, the disease is very easy to identify. Clinical signs of this form are elevated body temperature up to 38-39 degrees for 2 weeks, wet cough, muscle weakness, excessive sweating.
• The tumorous form is the most dangerous form of tuberculosis of the intrathoracic lymph nodes. In the child's body, several lymph nodes are affected with the formation of pus in them. The disease develops with pronounced symptoms of intoxication, whooping cough and shortness of breath.

Other types of respiratory tuberculosis are also known:

1. The primary tuberculosis complex is the primary form of tuberculosis. An inflammatory process develops in the affected organ, which spreads through the lymphatic tract. It can only be recognized by the attending physician based on the results of the patient's X-ray. The main signs are a pronounced intoxication syndrome, a strong cough, sometimes with shortness of breath.
2. Focal pulmonary tuberculosis in children is a form of tuberculosis that mainly affects children over 10 years of age. Pathogenic inflammatory process is localized in the chest area. In this case, the baby may not be disturbed by anything.
3. Tuberculoma of the lungs is a form of the disease in which the infection affects a large area of ​​\u200b\u200bthe organ of 10 mm. The only symptoms of pulmonary tuberculoma are a periodic wet cough with sputum.
4. Tuberculous pleurisy is characterized by well-defined clinical symptoms. The first signs of the disease are pain in the chest area, fever up to febrile levels, intoxication syndrome.
5. Tuberculosis of the bronchi is a form in which the focus of inflammation is located in the bronchi. This disease belongs to the list of difficult to diagnose, since bronchoscopy has age restrictions. Its main manifestations are a strong, barking cough with sputum secretions, which is not treated with mucolytics.
6. Caseous pneumonia is the most dangerous and severe form of tuberculosis. Fortunately, children are rarely exposed to this disease. Caseous pneumonia entails many unpleasant symptoms - apathy, significant weight loss, severe shortness of breath.

Diagnostic methods

Diagnosis of tuberculosis during the incubation period allows you to cure it in a few months. Timely and effective therapy determines the mild course of the disease and guarantees its favorable outcome.

Infants who do not go to a kindergarten or school where regular medical examinations are carried out should have a blood test at least once a year (we recommend reading:). Children who are suspected of having TB by pediatricians are referred for consultation with a TB specialist. This doctor prescribes such preventive and diagnostic measures as:

• general and enzyme immunoassay, which reveals inflammation in the asymptomatic course of the disease;
• Mantoux test;
• X-ray of the lungs in children under 15 years of age or fluorography for patients over 15 years of age, which is performed to visualize local changes in the photo;
• computed or magnetic resonance imaging;
• ELISA-, PCR-studies that determine the causative agent of a pathogenic inflammatory process.

Mantoux test

The Mantoux test is an injection of tuberculin under the skin. Tuberculin consists of pathogens that should cause an allergic reaction if there is an infection in the child's body (we recommend reading:). Three days after the injection, the doctor visually determines its result:

• negative - the injection site has not changed in size (the permissible norm is an increase of 1 mm), redness and compaction were not detected (for more details, see the article:);
• controversial - at the injection site there is an increase of 2-3 mm, slight redness or induration;
• positive - the sample has grown to 5-7 mm.

Blood analysis

The asymptomatic course of tuberculosis requires confirmation of the diagnosis, therefore, to begin with, the pediatrician prescribes a general blood test, which reveals inflammation. With a positive result, the doctors refer the patient to an enzyme immunoassay to determine the presence or absence of tuberculosis antibodies. The patient receives the results of both tests on the day they are performed. This method cannot be considered particularly informative, unlike X-ray and PCR (we recommend reading:).

PCR diagnostics

Polymerase chain reaction is guaranteed to give an accurate result, which allows you to identify the disease at any stage of development, including during the incubation period.

The result of the study is given to the patient in a few days. This diagnostic method determines the causative agent of the disease in the blood, urine or sputum of the baby, allowing it to be destroyed as soon as possible through drug therapy.

Tuberculosis treatment

Therapy of a child with tuberculosis is largely determined by the form of the disease, as well as the age category of the baby. This disease requires an individual approach to prescribing drugs, but there is a general treatment regimen.

The main method is chemotherapy using various groups of drugs. The use of antibiotics for the treatment of tuberculosis cannot be considered effective, since mycobacteria are not sensitive to their action. At the initial stage, doctors prescribe Isoniazid and Rifampicin to babies, adding Streptomycin or Ethambutol to them a month later. Anti-tuberculosis drugs are taken for at least 3 months, after which the phthisiatrician prolongs or stops the appointment, depending on the form and stage of the disease.

In parallel with these drugs, children are prescribed immunostimulating drugs, and they also give recommendations regarding the prevention of the disease. At the end of the main course of treatment, the child can be given a ticket to a sanatorium, where he will continue physiotherapy.

Incorrectly selected treatment has detrimental consequences. Firstly, ineffective therapy will not bring any benefit to the child and will lead to an aggravation of the disease, that is, damage to vital organs. Secondly, such treatment will contribute to the formation of a drug-resistant form of the disease, as a result of which pathogenic pathogens will stop responding to any, including effective, drugs.

Lifestyle during treatment

In case of tuberculosis of the intrathoracic lymph nodes or any other primary form of the disease, it is very important to observe the following measures:

• Relaxation. Parents should exclude overfatigue of the baby, because during the treatment the body constantly needs strength to fight the infection and actively recover.
• Proper diet. The child should get used to a well-organized three or four meals a day, depending on age. The disease often causes disturbances in appetite, but parents should ensure that the baby does not miss a single meal per day.
• Healthy diet. The nutrition of a sick child should be enriched with vitamins and minerals. Eating healthy vegetables and fruits along with staple foods is the key to recovery. The child is put on a diet No. 11 for the duration of treatment, which excludes spicy and fried foods, and also minimizes sweets.
• Avoiding crowded places where the baby can re-infect. A child with tuberculosis should minimize visits to public places. Firstly, parents should not forget that he is a carrier of mycobacteria. Secondly, there is a possibility of re-infection with a new infection, since the immunity of a small patient is very weakened.
• Staying warm. The child needs to be provided with warmth, since hypothermia entails the emergence of a new disease, which will be difficult for the body to cope with due to a decrease in its defenses.

Disease prevention in children

Prevention of tuberculosis in children implies the following conditions:

• vaccination, including the first BCG vaccination in the maternity hospital, the Mantoux test and other preventive vaccinations;
• hardening of children through regular walks in the fresh air in any weather;
• exclusion of contact with potentially infected people.