Tuberculosis Study Guide - M.M. Savula 2002

Primary Tuberculosis in Children

Initial infection of a child with mycobacteria, and even their penetration into the body's internal environment, does not always lead to disease. Most often, newly infected children or adolescents feel healthy, and no abnormalities are found during their examination. However, the pathogen circulates in the body, settles in Tissues, and is capable of causing pathological changes. A particularly high risk of developing the disease exists within one year from the moment of tuberculin conversion (the early period of Primary tuberculosis infection); therefore, during this period (1 year), children are placed under clinical supervision and receive 3 months of preventive Treatment.

Tuberculosis is more likely to develop following repeated exposure to large amounts of Mycobacterium tuberculosis combined with reduced host resistance, which may be caused by comorbidities, hypothermia, malnutrition, or congenital immunodeficiencies.

The dissemination of MTB through hematogenous and lymphatic pathways explains the potential involvement of various Organs and systems, although the Respiratory system remains the most common site of the disease.

Tuberculosis that develops As a result of primary MTB infection is called primary tuberculosis. It is usually diagnosed in children or adolescents, and rarely in adults. It presents in the following main clinical forms:

- Tuberculous intoxication in children;

- Primary tuberculous complex;

- intrathoracic Lymph node tuberculosis;

- Primary tuberculosis in children and adolescents may also manifest as Pleurisy, Disseminated Pulmonary Tuberculosis, and various extrapulmonary forms of tuberculosis.

All forms of primary tuberculosis are characterized by:

♦ recent tuberculin Skin test conversion;

♦ hypersensitivity to the tuberculosis pathogen and its breakdown products, manifested by pronounced cutaneous reactions to tuberculin, and sometimes by toxico-allergic (paraspecific) manifestations;

♦ involvement of Lymph Nodes (primarily intrathoracic) with a tendency toward caseous necrosis;

♦ frequent dissemination of infection via lymphatic and hematogenous pathways;

♦ the potential for spontaneous healing.