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Tuberculous intoxication in children and adolescents
Last reviewed: 20.11.2021
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Tuberculosis intoxication in children and adolescents occurs when tuberculosis is infected and the development of a primary tuberculosis infection without local manifestations determined by radiological and other research methods.
Tuberculosis intoxication is detected in children (adolescents) with first positive, increasing in the course of observation and hyperergic reactions to tuberculin. It is characterized by the activity of the tuberculosis process and is accompanied by the following symptoms:
- deterioration of the general condition of the child (adolescent), expressed in a periodic increase in body temperature to subfebrile digits, deterioration of appetite, the appearance of neurovegetative disorders (increased nervous excitability or its stigma, headache, tachycardia);
- a slight increase in peripheral lymph nodes (micro-polyanidia) with phenomena of periadenitis;
- a slight increase in the liver (less often - the spleen);
- stopping physiological gain or lack of body weight;
- tendency to intercurrent diseases;
- a change in the pattern of peripheral blood (an inconspicuous increase in ESR, a shift of the leukocyte formula to the left, eosinophilia, lymphopenia);
- change in the immunological status (decrease in the number of T-lymphocytes and their functional activity).
Specificity of the described functional disorders should be confirmed by a thorough examination of the child (adolescent) to eliminate nonspecific diseases. During the examination it is necessary to use modern diagnostic methods, including radiograph in direct and lateral projections, mediastinal tomography in various projections, bronchoscopy, tuberculin-provoking tests (hemotuberculin, immunotuberculin, etc.) before and after subcutaneous injection of tuberculin-10-20 TE PPD-L. As well as bacteriological study.
Diagnosis of tuberculosis intoxication in children and adolescents includes mandatory examination to exclude the rare localization of tuberculosis with lesions of the abdominal cavity organs or small forms of tuberculosis of the intrathoracic lymph nodes.
Differential diagnosis is carried out with chronic nonspecific lesions of the ENT organs, helminthic invasions and other diseases accompanied by signs of a general intoxication syndrome.
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