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the characteristic of group of children with positive takes of revealing of micobacteria of a tuberculosis

In group of children c local forms of a tuberculosis had been taped 12 patients bakteriovydelitelej. Considering, that revealing of micobacteria of a tuberculosis is absolute diagnostic criterion

Specific tubercular process, we have carried out the analysis of this group of patients.

Among children allocating MBT, there were 9 girls and 3 boys. At distribution on age, it is taped, that among children till 7 years there was one boy of 2th years. Children at the age of 8 - 14 years (5 girls and one boy) and 15 - 17 years (4 girls and one boy) prevailed. Thus, in our research, a tuberculosis micobacterium in 3 times (tab. 13) were more often taped at girls.

Table 13

The characteristic of children allocating MBT, on a floor and age

Age Girls

abs.

Boys

abs.

In total

abs.

Till 1 year 0 0 0
1 - 3 years 0 1 1
4 - 7 years 0 0 0
8 - 14 years 5 1 6
15 - 17 years 4 1 5
In total 9 3 12

At all children, extractors of a micobacterium of a tuberculosis, bacterination presence (and revaccinations) BCG and its efficiency has been studied.

Vaccinated BCG children there were 10 persons, from them one child was revaktsinirovan (had a scar after revaccination BCG). Among vaccinated BCG children, at 4 patients noneffective bacterination (weakly expressed scar to 3 mm, a negative Mantoux reaction 2 THOSE in 1 year) became perceptible.

At studying of the epidemiological anamnesis contact with sick of a tuberculosis at 5 patients is come into.

At studying of clinical forms of a tuberculosis at children with bakteriovydeleniem it is taped, that the basic form was infiltrativnyj a pulmonary tuberculosis (9), and by a bacterioscopic method of a micobacterium of a tuberculosis were taped only at this form of specific process (4 cases) (tab. 14).

Table 14

Distribution of positive takes of revealing of micobacteria of a tuberculosis depending on the tuberculosis form

The tuberculosis form Bacterioscopic method (abs) Bacteriological method (abs)
TVGLU 1
Primary tubercular complex 1
Infiltrativnyj a pulmonary tuberculosis 4 9
Focal tuberculosis

Lungs

1
In total 4 12

At studying of a way of revealing of a tuberculosis it has been established, that the majority of children (10 persons) have been taped at routine inspections: during a mass tuberculinodiagnosis infectious character tuberkulinovyh assays at 7 children (on "bend" tuberkulinovoj assays - 2 has been taped; sensitivity increase to a tuberculin - 5); on contact - 2; at fluorographic inspection - 1.

At the reference with complaints from the general medical network 2 persons (at these children retrospektivno monotonous character tuberkulinovyh assays is taped) are taped.

Carrying out the analysis of an accompanying pathology, it is found out, that more often in the given group there were children an anaemia of various severity level - 3 patients; 1 person consisted on the dispensary account apropos perinatalnoj pathologies TSNS; as on one patient epilepsies were observed concerning a bronchial asthma, a dyskinesia zhelchevyvodjashchih ways (DZHVP).

At carrying out of standard inspection to all children the sensitivity estimation to a tuberculin on a Mantoux reaction in standard delution and expression of assay with preparation Diaskintestj (tab. 15) is spent

Table 15

Distribution of children by results of a Mantoux reaction with 2 THOSE ППД-Л2

Result of assay Mantoux reaction 2 THOSE

Quantity (abs.)

Diaskintest

Quantity (abs.)

The negative 0 1
The doubtful 0 0
Infiltrate to 5 mm 0 0
5-9 mm 3 1
10-14 mm 9 7
15-16 mm 0 3

17 mm and more 0 0
In total 12 12

At all children who are bakteriovydeliteljami, the positive Mantoux reaction with 2ТЕ became perceptible, thus expression of reaction was various.

The majority of children the expressed positive assays had of 10-14 mm (9 persons); at 3 children positive reactions of 5-9 mm became perceptible. The average size of a papule has made 9,25мм (±4,5мм).

After an estimation of results of assay Diaskintestjvyjavleno, that the expressed positive assays with the size of a papule 10-14мм - 7 persons had the majority of children. Results of assay Diaskintestjs of 5-9 mm are taped by an infiltrate at one child (7 mm). Hyperergichesky assays were at 3 persons. Assay with Diaskintestjv one case has appeared negative (at the teenager with infiltrativnym a pulmonary tuberculosis). The average size of a papule has made 10мм (±5мм).

At carrying out of the comparative characteristic of the sizes of a papule at positive takes of Mantoux reactions 2 THOSE and Diaskintestjustanovleno, that the majority of children had the size of a papule 10-14мм - 9 and 7 persons accordingly. But the quantity of assays with slabopolozhitelnym result was more on a Mantoux reaction 2 THOSE, and with giperergicheskim - at assay with preparation Diaskintestj.

Thus, at an active tuberculosis with bakteriovydeleniem, assays with preparation Diaskintestjimejut more expressed character, but in one case assay was negative.

To all children medicinal sensitivity MBT is defined. At definition of medicinal sensitivity (TLCH) in 2 (16,7 %) cases
Plural medicinal fastness is taped: in one case fastness to Isoniazidum and rifampicin; in the second - to Isoniazidum, rifampicin, streptomycin and Ethambutolum. The size of assays at them was on a Mantoux test 2 THOSE 5-9мм, on assay with preparation Диаскинтест®15-16мм. These children were from contact to adults sick of a tuberculosis at which plural medicinal fastness also was defined.

Thus, the given analysis has shown, that bakteriovydelenie has been established in 12 % of cases from all local forms of a tuberculosis. The majority of children is taped at verifying surveys by results of a tuberculinodiagnosis. The analysis of previous Mantoux reactions with 2ТЕ has shown, that at 2 children "bend" tuberkulinovyh assays has been taped; at 5 children increase tuberkulinovoj sensitivities became perceptible. At the patients taped at the reference in the general medical network, monotonous character tuberkulinovoj sensitivities is established. At studying of risk factors it is established, that at 40 % of children from vaccinated BCG noneffective bacterination became perceptible. The great value had revealing of contact to a sick tuberculosis. Two children have been taped on contact, at 3 patients it was possible to come into contact at the anamnesis collecting. Accompanying diseases had 7 persons. The analysis of expression of dermal assays in group of children allocating micobacteria of a tuberculosis, has shown, that more often assays have the sizes 10-14мм both on a Mantoux reaction 2 THOSE, and on assay Diaskintestj, but at assay with preparation Diaskintestjbolshe expressed and giperergicheskih results. For revealing of local forms of a tuberculosis the great value has the complex approach with the account as results of a planned tuberculinodiagnosis, and work with risk groups. Diaskintestjpokazal high efficiency in this group, except for one case infiltrativnogo a pulmonary tuberculosis in a disintegration phase.

3.3.

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Scientific source Ahmerova Tatyana Efimovna. IMMUNODIAGNOSIS OF DIFFERENT MANIFESTATIONS OF TUBERCULOSIS INFECTION IN CHILDREN. Thesis for the degree of candidate of medical sciences. SAMARA - 2014. 2014

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Other medical related information the characteristic of group of children with positive takes of revealing of micobacteria of a tuberculosis:

  1. THE TABLE OF CONTENTS
  2. Diaskintestj in diagnostics of a tubercular infection
  3. the characteristic of group of children with positive takes of revealing of micobacteria of a tuberculosis
  4. CHAPTER 4. DISCUSSION
  5. THE LITERATURE LIST