| Miliary Tuberculosis in Children and Adults |
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Duck Lim, Chan Sae Lee |
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Department of Medicine, College of Medicine, Kyung Hee University, Seoul, Korea |
| 속립성 결핵의 임상적 고찰 -성인과 소아의 차이- |
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임덕, 이찬세 |
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| Abstract |
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The authers made an analytic review of clinical records on 30 cases of miliary tuberculosis admitted at Kyung Hee Univ. Hospital during last 4 years from Jan. 1973 to Mar 1977 to find the differences between children and adults patients. There were 11 cases of adult patients and 19 cases of children, but 3 cases of children were omitted from this study for insufficient recordings.
The results were as follows.
1) There were definitely more miliary tuberculosis among children than among adults. The ratio of miliary to total pulmonary tuberculosis patients admitted during the same period was 15. 1% in children and 2.3% in adults. Also the percentage to the total admitted patients of Internal Medicine and Pediatrics was 0.2% and 0.6% respectively.
2) The most prevalent age group among children was between one and three years old showing 63.1%, and among adults it was third decade of age group showing 36.3%. However the sixth decade of age group also showed relatively high prevalance (27.3 %) .
3) The majority cases (84.2%) of children were combined with tuberculous meningitis,
while only 27.3% of adult cases were combined with meningitis.
4) There was no past history of tuberculosis in children's cases, but positive family histories were 43.7%. There was one case of child had the B. C. G. vaccination. Among adult cases 36.4% had the past history of tuberculous infection.
5) The precipitating factors to causes miliary tuberculosis were uncertain in most cases,
but there were 3 cases of measles and one case of pertussis preceded this disease among children's cases, and among adult cases one case developed during pregnancy and one case was postpartum.
6) The main symptoms were high fever, cough, vomiting, loss of consciousness, convulsion and diarrhea among children’s cases, and high fever, cough, headache, epigastric pain and dyspnea among adult cases. The symptoms of loss of consciousness, vomiting and convulsion were more frequent in children's cases.
7) The remarkable physical signs were neck stiffness (68.8%), hepatomegaly (62.5% ), splenomegaly (25%) among children, but among adult cases, those signs were not remarkable showing only 27.3% of neck stiffness and hepatomlgaly each.
8) The sputum culture for M. tuberculosis were performed all of adult cases with positive result of 27.3%, but among children’s cases only 4 cases were examincd with all negative results.
9) The duration of admission treatment were mostly very insufficient. However 62.5% of children’s cases and 54.5% of adult showed some improvement. 37.5% of children and 27.3% of adults showed no improvcment or some progression of the disease. |
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