South African Medical Journal
Journal / South African Medical Journal / Vol. 85 No. 7 (1995) / Articles

download PDF

Published:

May 9, 2017

Issue

Vol. 85 No. 7 (1995)

Section

Articles

Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].

Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.

Previously published images

If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.

Author Biographies

RP Gie

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

N Beyers

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

HS Schaaf

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

ED Nel

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

NA Smuts

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

S van Zyl

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

PR Donald

Departments of Paediatrics and Child Health and Radiology, University of Stellenbosch, Tygerberg, W. Cape

RP Gie

N Beyers

HS Schaaf

ED Nel

NA Smuts

S van Zyl

PR Donald

Abstract

Object: The aim of the study was to identify diagnoses that are confused with pulmonary tuberculosis in children. Design: Prospective, investigative clinical study. Setting: Tertiary care teaching hospital and an urban tuberculosis clinic in an area with a very high incidence of pulmonary tuberculosis (> 800 new cases/100 ODD/year). Patients: Children suspected of having tuberculosis, children followed up for pulmonary infiltrates with eosinophilia and children with congenital pulmonjiry anomalies were investigated. Intervention(s): None. Outcome measure: Pulmonary tuberculosis was diagnosed using modified World Health Organisation criteria and the diagnoses of those children not suffering from pulmonary tuberculosis were analysed. Results: Of the 354 children initially suspected of suffering from tuberculosis 71 (20%) were found to be suffering from other pulmonary disease, viz. pneumonia or bronchopneumonia (29%), bronchopneumonia with Wheezing (18%), and asthma with lobar or segmental collapse (12%). Of 14 children suffering from pulmonary infiltrates with peripheral eosinophilia 6 (43%) were initially incorrectly diagnosed and treated for tuberculosis. Of 54 children with congenital pulmonary anomalies, 8 (15%) were treated for tuberculosis before the correct diagnosis was made. Congenital anomalies most often confused with tuberculosis were unilateral lung hypoplasia, bronchogenic cyst and tracheal bronchus with an anomalous lobe. Conclusions: The criteria for diagnosing tuberculosis in children is complicated in areas with a high incidence of tuberculosis and poor socio-economic circumstances where many children presenting with conditions other than tuberculosis will be in contact with an adult case of pulmonary tuberculosis. The commonest conditions confused with tuberculosis are pneumonia, bronchopneumonia and asthma. Pulmonary infiltrates with peripheral eosinophilia and congenital lung abnormalities should be considered especially if the children have an atypical clinical picture or do not respond to tuberculosis treatment.

S Afr Med J 1995; 85: 658-662

Journal Identifiers

eISSN: 2078-5135
print ISSN: 0256-9574