Classical Diagnosis of Tuberculosis
Pp. 35-48 (14)
Roberta O. Pinheiro and Paulo R.Z. Antas
The diagnosis of children tuberculosis involves the clinical, epidemiology and image
methods, as well as the results of a tuberculin skin test. Tuberculosis can mimic many common
childhood diseases, including pneumonia, generalized bacterial and viral infections, malnutrition and
HIV. The main impediment to the accurate diagnosis of active tuberculosis is the paucibacillary nature
of the disease in children. Although the diagnosis of tuberculosis disease in adults is mainly
bacteriologic, in children it is usually epidemiologic and, therefore, indirect. In the absence of accurate
diagnostic tools for tuberculosis in children, both underdiagnosis and overdiagnosis are common. The
overdiagnosis is exacerbated in areas with a high prevalence of HIV and tuberculosis because both
share many clinical features, often making it impossible to exclude tuberculosis in HIV-infected
children. Many adults who develop infectious reactivation of tuberculosis acquired the infection during
childhood. Given the effectiveness of isoniazid preventive therapy to stop progression of active
tuberculosis, accurate diagnosis and treatment of M. tuberculosis infection in children would reduce
many cases of contagious, adult, tuberculosis in the future.
Children Tuberculosis, Clinical Diagnosis, Radiological Diagnosis, Bacteriological Diagnosis,
Immunological and Biochemical Diagnosis.
Leprosy Laboratory, Fiocruz, Av. Brasil, # 4365; zip: 21045-900, Rio de Janeiro, Brazil.