Mültecilerin kabulünden sonra bir referans çocuk hastanesinde çocukluk çağı tüberkülozu

Öz

Amaç: Pediatrik tüberküloz (TB) hastalarının epidemiyolojik, klinik, laboratuvar, mikrobiyolojik özellikleri, tedavisi ve sonuçlarını değerlendirerek göçmen hastalara dikkat çekmeyi amaçladık. Gereç-Yöntemler: Ocak 2015-Eylül 2016 tarihleri arasında 18 yaş altı TB'li çocukların tıbbi kayıtlarını geriye dönük olarak incelendi. Bulgular: Yaş ortalaması 135,5 ± 52,6 ay olan 13'ü (%65) kadın ve 7'si (%35) erkek olmak üzere toplam 20 TB hastası (%35'i Suriyeli mülteci) değerlendirildi. On dört (%70) hasta ergendi. Yedi (%35) hastanın aktif bir TB hastası ile temas öyküsü mevcuttu. Dört (%20) hastanın başvuru anında hiçbir şikayeti yokken en sık görülen semptom 2 haftadan uzun süren inatçı öksürüktü. On beş (%75) hastanın Bacillus Calmette-Guérin skarı vardı. Onaltı (%80) hasta tüberkülin deri testi (TDT) pozitifti. Toplam dört (%20) hastada mikrobiyolojik doğrulama sağlandı. Başvuru anında en sık görülen akciğer grafisi bulgusu hiler lenfadenopatiydi. On (%50) hastanın akciğer grafisi normaldi ve anormal toraks tomografi bulguları ile tanı konulmuştu. Yalnızca miliyer tüberküloz tanısı ile izlenen bir hastada tedavi başarısızlığı olup hasta kaybedilmişti. Sonuç: Tüberküloz önemli bir bulaşıcı hastalık olup çocuklarda mikrobiyolojik doğrulama her zaman olmayabilir. Çocukluk çağı TB tanısı, temas öyküsü, pozitif TDT reaksiyonu, uyumlu spesifik olmayan semptomlar ve radyolojik bulgularla doğrulanabilir. Tüberküloz hastalığının epidemiyolojik özellikleri ve yaşadığımız yerdeki göçmen yoğunluğu dikkate alınarak Suriyeli mültecilere özel dikkat gösterilebilir.

Anahtar Kelimeler

• Çocuk
• Suriyeli mülteciler
• tüberküloz

Childhood tuberculosis in a reference children's hospital after admission of refugees

Öz

Aim: We aimed to evaluate epidemiologic, clinical, laboratory, microbiologic features, treatment and outcomes of pediatric tuberculosis (TB) patients also to draw attention to immigrant patients. Material- Methods: We retrospectively conducted the medical records of children below 18 years of age with TB between January 2015 and September 2016. Results: A total of 20 TB patients (35% were Syrian refugees, total 65% female) with a median age of 135.5±52.6 months were evaluated. Fourteen (70%) patients were adolescent. The history of contact with an active TB disease patient was found in seven (35%) patients. Four (20%) patients had no complaint at admission whereas the most common symptom was prolonged cough > 2 weeks. Fifteen (75%) patients had a Bacillus Calmette–Guérin scar on the left shoulder. A total of 16 (80%) patients had a positive tuberculin skin test (TST) result. Microbiological confirmation was provided in four (20%) patients totally. The most common chest X-ray findings on admission were hilar lymphadenopathy. Ten (50%) patients had normal chest X-ray and were diagosed with abnormal thorax tomography findings. All of the patients were treated succesfully except one Syrian patients with miliary TB who died. Conclusion: Microbiological confirmation of childhood TB may be absent and the diagnosis can be confirmed in the light of contact history, positive TST reaction, compatible symtomps and radiological evidence. Particular attention might be paid to Syrian refugees, taking into epidemiological characteristics of TB disease and the density of immigrants in the place we live in.

Anahtar Kelimeler

• Syrian refugees
• tuberculosis
• children

Kaynakça

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