Extrapulmonary tuberculosis in pediatric patients- A matter to worry??MRI

Abstract

Introduction: Tuberculosis(TB) is still a major problem worldwide, it is estimated that, one third of the world population is affected with TB. Extrapulmonary TB accounts for 10-15% of tuberculosis worldwide. Pediatric TB is ignored mainly due to the fact that BCG vaccine will provide protection. Cartridge Based Nucleic Acid Amplification Test (CBNAAT) gives results in 4-5 hours and is therefore widely used. Aims and objectives: 1.To study the age and sex distribution of pediatric patients suspected to have extra pulmonary tuberculosis.2.To detect tuberculosis in extra pulmonary samples in pediatric patients by GeneXpert.3.To detect the rifampicin resistance in these cases.4.To evaluate the co-occurrence of HIV with tuberculosis in these cases.Material and methods: Retrospective study was conducted from 1st January 2016 to 31st December 2020. GeneXpert was done on all the clinically suspected cases of extrapulmonary tuberculosis. Results: Cerebrospinal fluid (CSF), Gastric lavage and Pleural fluid were the major samples received (31.15%, 29.91% and (22.94%) respectively. Majority of suspected patients were from less than 3 years age group (54.92%). Minimum age found was 1.5 month child. Males predominated females in clinically suspected cases M:F ratio was 1.37:1. 86.47% negative by GeneXpert and 12.29% were positive. Rifampicin sensitive were 8.61%, Resistant were 0.82%.In positive cases female outnumbered males. 3.28% pus samples were positive, 2.46% CSF was positive. There was no co-infection of HIV with Tuberculosis in our study. Conclusion: We found a rise in cases of extrapulmonary tuberculosis as compared to our previous study. This may be due to proper detection of cases, interaction with clinicians and encouraging them to send the suspected samples in microbiology department. CSF samples constituted 31.15% of total sample. This alarm us the increase in meningeal tuberculosis cases.