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ABSTRACT: IntroductionTuberculosis remains one of the major problems of the public health in particular in the countries in the process of development. During the last decade, the frequency of the extrapulmonary localizations seems in increase. The purpose of this study was to analyze the cases of extrapulmonary tuberculosis (EPTB) at department of pediatrics in CHU Hédi Chaker, a regional hospital who receive children going from all the south of Tunisia.Patients and methodsWe made a retrospective study during 14 years from January 1994 to December 2007. Characteristics of demography, clinical features were obtained from medical case records. Diagnosis of EPTB was confirmed by bacteriology and/or the histology.ResultsThere were 20 cases of EPTB (52.6%) and 18 cases of pulmonary tuberculosis (PTB) (47.3%). The mean age of EPTB patients was 6.5 years. The male to female ratio for EPTB was 0.81. Vaccination by the BCG was reported in all patients. The common sites of extrapulmonary involvement were the lymph nodes (45%), followed by the bones and spine (25%), peritoneous (10%), intestinal (5%), the meninges and brain (10%) and the kidney (5%). The positive diagnosis was obtained by isolation of BK in the culture of the cerebral spinal fluid in two children and the histopathologic study in 18 patients. The evolution was marked by occurred of hydrocephalus in two patients having a meningitis tubercular. The evolution was favorable in all the other cases.ConclusionThis study shows the frequency of the EPTB in children despite the efforts made in the fight against the tuberculosis in our country and this confirms that the protection conferred by BCG vaccination when applied to newborns does not protect perfectly.
Journal de Pédiatrie et de Puériculture 12/2010; DOI:10.1016/j.jpp.2010.07.002