If the child is infected with tuberculosis what to do. Tuberculosis bones and joints

Tuberculosis is infectious damage The organism, the causative agent of which is bacterium - Koha's wand, named after its opener. Symptoms are not developing at this disease immediately, that is, it has an incubation period from 3 months to 1 year.

This deals are characterized by the presence of specific tuberculosis formations. The targets at the same time can be light, kidney, brain, intestines, eyes. He affects both adults and children.

Children's tuberculosis is particularly dangerous, as heavier is heavier and has a lot of consequences.

The cause of tuberculosis is the contact of the child with a sick person. As a rule, this is someone from family members. The disease is transmitted by air-drip, domestic, alimentary, as well as from the mother to the fetus. Can be facilitated by:

• reducing immunity due to frequent colds, HIV infection, hormonal therapy, antibacterial drugs;
• the absence of active immunity, which occurs, if the child did not make an appropriate vaccination;
• an unfavorable social environment.

Pathogenesis of the disease

Mycobacterium tuberculosis has considerable stability both in the environment and in the human body.

Covering the protective sheath, the tuberculous wand may exist in the body of the carrier and not cause diseases under the condition of good immunity.

Implementing into a person's body, mycobacterium primarily enters the lymphatic system, and lymphocytes are the first cells that arise to combat it. If they do not cope with the task, the causative agent enters the blood and is dealt with blood flow to the organs.

Having settled in the target organ, the causative agent forms a caseous cluster of cells in the form of a bugor - granule. From granuloma, accompanying other diseases, it is distinguished by the presence in the center of a necrotized focus having a consistency of cottage cheese. When these formations are bursting, the set of koch sticks are scattered in the body or fall into the nearby fabrics of the affected organ. The burst formation begins to disintegrate, and then compacted, scarring and conquered, that is, to be covered with calcium salts.

The first signs of tuberculosis in children

At the beginning of development, the disease does not cause any symptomsThat is, it is located in the Promotional phase. It can last from 6 months to a year.

The only sign can be a positive reaction of Mantu.

After the hidden period, the child appears the first symptoms of the disease. They are manifested by tuberculous intoxication:

• reducing the activity of the child;
• dizziness, headaches;
• bad appetite, loss of body weight;
• temperature: Against the background of subfebilite, the temperature flashes flashes up to 39 °;
• increased sweating, especially at night. In particular, the palms and feet sweat abundantly;
• an increase in lymph nodes of several groups. They are soft and painless.

These primary signs are the manifestation of all types of tuberculosis.

Symptoms

After the stage of tuberculosis intoxication, a primary tuberculosis complex is developing. It can be formed in any organs, but the lungs are most often affected.

At the same time, the bacteria, choosing the most well-purged piece of lungs, accumulate in it and cause inflammatory focus. It grows, and the causative agents go to nearby lymph nodes, causing inflammation and there. Usually such a process develops in children with low immunity. Perhaps his independent cure.

Signs of lung tuberculosis in children in the early stages of the disease are all the same symptoms of intoxication, an increase in body temperature up to 37.5 °. Often the beginning of the disease can be confirable with respiratory infection.

Patients appear shortness of breath and cough. Cough in a child with tuberculosis is characterized by the duration of the flow - more than 3 weeks. At the beginning of the disease, it is dry, then replaces wet.

A characteristic feature is the discharge of sputum with blood.

Such kids are very thin, pale, and the cheeks are burning a blush. The painful brilliance of the eyes appears.

When involving the mediastinum and pulmonary roots in the process of lymph nodes, bronchigoenitis develops. The above symptoms are joined painfulness Between the blades, rough, whistling exhalation as a consequence of the compression by the bronchi or trachea increased in the sizes.

Cough also accompanies this pathology. It is a dry and fitful, reminds of cough. In the upper part of the chest appears the venous drawing.

Localization classification

Tuberculosis is a disease that can affect any organs. It all depends on where mycobacterium will fall into the blood. Depending on the affected system, there are several types of its species.

Pulmonary tuberculosis including:

1. Primary tuberculosis complex.
2. Bronshignit.
3. Tuberculosis bronchi, lungs, upper respiratory tractth.
4. Tuberculous Purrites.
5. Pulmonary tuberculosis:
   • focal - Formation B. pulmonary fabric small areas of lesion (within 1 segment);
   • cavernous- in the lungs the cavity is formed without signs of inflammation;
   • fibrozno-cavernous. There is a sealing of the cavernous cavity and nearby lung tissues;
   • cyrrotic - pulmonary tissue is replaced by a connecting due to which the light loses elasticity;
   • disseminated- severe form of tuberculosis infection, in which multiple focal lesions appear in the lungs. Then infection with blood flow, lymphs fall into other organs;
   • miliary - view of the disseminated tuberculosis, in which multiple foci formed in the lungs have small dimensions;
   • infiltrative - characterized by the formation of the inflammation area in the pulmonary fabric with necrosis in the center;
   • tuberculle - This is tuberculous inflammation in a capsule of more than 10mm.

Symptoms and treatment of pulmonary tuberculosis in children depend on the location of the localization and the degree of severity of the process. But still signs of manifestation of similar among themselves: this is cough, hemoptia, shortness of breath, chest pain.

Tuberculosis brain shells . The most common form is tuberculous meningitis. At the same time, the lesion of the shells of the brain occurs. The process is accompanied by strong headaches, mood lability, high temperatures, vomiting, muscle hypotension.

Tuberculosis of the musculoskeletal system In turn, it is divided into:

• tuberculosis of the spine - The process at the beginning of the disease is limited to 1 vertebra. Therefore, intoxication I. pain syndromes expressed weakly. As the process progresses, the symptoms are growing. There are sharp pain in the spine of various character and the voltage of the vertebrates. To reduce pain, a person takes a forced position. He is changing the posture and gait. The chest is strongly deformed, the curvature of the spine is developing;
• tuberculosis joints It is characterized by the soreness of the affected articular region. The skin over it is dense, hot to the touch, the swelling is expressed. First, the flexion and extension of the joint occurs, then its complete immobility comes. The general condition is violated;
• tuberculosis bones accompanied by pains in the bones, and, as a result, violation of the function of the organ. It should be noted that the cause of the bone system tuberculosis, in addition to the general
  The reasons for tuberculosis is the overload of the musculoskeletal system.

Tuberculosis kidney . Its symptoms are painful sensations in the back, pain in urination, blood in the urine, violation of the general condition.

Lupus. Among children is the most common skin symptomlike tuberculous Shankr: First, a reddish seal appears on the skin, which is then turning into an ulcer. It is painless, lymph nodes located near it are inflated on his background.

Another type of child skin tuberculosis is its change in the zone of the affected lymphatic node. The skin above it becomes a blue, then ulcerated. Such formations are painless. Small hillocks covering face and neck can also appear. If you press them, they turn yellow.

Peripheral tuberculosis lymph nodes children are accompanied by a painless magnification. They are movable. With increasing inflammation - burst, forming a fistula with purulent separated. Hyperthermia appears up to 40 °, headaches. The most often amazed submandibular, chin and cervical lymph nodes.

Tuberculosis of the intestine Accompanied by pain in the stomach, intestinal peristaltics disorders, a chair with blood, hyperthermia. The general condition is also violated.

Tuberculosis of the eye causes a decrease in vision, light-free, tearfulness. There appears black or clouding in the eyes, pain.

It is important to know that tuberculosis can occur in open form, that is, with the release of koche sticks in environment, and, therefore, with further infection in contact with the sick people. It can also be in a closed form at which the bacteria do not fall into the external space.

Features of tuberculosis in children and adolescents

Tuberculosis for children - extremely severe illness that leaves after a number of complications.

Features of the flow of tuberculosis in children under 2 years Characterized by the special severity of the process. As a rule, it is generalized. From the primary hearth with blood flow pathogenic microorganisms Find over the authorities, significantly complicating the condition of the child. Such kids often develop disseminated, meningial tuberculosis and even sepsis.

In older children The immune system is more perfect. It allows you to localize the process, not allowing its generalization. It is characterized by tuberculosis of lymphatic nodes.

Than younger child, the worse it transfers the disease. This is due to the peculiarity of the children's body: his immune system is still immature, incomparated, because of this, it cannot full extent resist infection.

The following critical age for the development of the disease - teenage. It is also distinguished by scattered forms of infection, with damage to the lungs and brain. This is due to hormonal splash, which lead to an imbalance in the body, and, as a result, reduced ability to resist death.

The form of the disease, which is found only in children, is congenital tuberculosis.

Fetal infection occurs from the patient of the mother through the placenta or when swallowed by a child of spindle water. At the same time, the causative agents of the disease with a blood flow are primarily transferred to the kid liver, where the initial focus of the pathological process is formed.

Such children appear to light premature. A month later, the first symptoms of the disease begin to appear: hyperthermia, depression or anxiety. Symptoms develop very quickly respiratory failure. Often infection causes inflammation of the shells of the brain. At the same time, signs of damage to the central nervous system are observed, the tension of the occipital muscles, separation from the ears.

The most common type of children's tuberculosis is the defeat of the pulmonary fabric. The pulmonary tuberculosis in children is found in 80% of cases. Therefore, the appearance of a cough child who does not pass within a month, and an increase in temperature should alert the parents and become a signal to the child survey.

Most effective method Prevent tuberculosis is a BCG vaccine. It is weakened strains of tuberculosis sticks. Vaccination for newborns is less aggressive. Apply for it bCG-M vaccine. For the first time, tuberculosis vaccine was made in France in the 20s of the 20th century.

Dates of Vaccination BCG.:

• held in the hospital newborn kids for 3-7 days of life;
• RV1 (i.e. 1 revaccination) is carried out at 7 years;
• RV2 is held in 14 years of healthy children.

Immunity after the BCG vaccination is formed after 2 months and protects the child from tuberculosis for 4 years. Especially important for children early agesince tuberculosis for them can become a fatal disease

Vaccination make in the upper outer third of the shoulder intracudino. First, a small swelling appears at the injection site. Then she goes into the pustula - a bubble with liquid. Pustula burst, forming a small yazelka. The ulcer is covered with a crust. After 6 months, the scar is formed in her place. It Must be 5-8mm. This indicates successful vaccination.

Sometimes after vaccination there is no trace. This may indicate congenital immunity to the disease.

Complications after the administration of tuberculosis vaccine can become:

• cold abscess;
• Btzit;
• keloid scar.

Contraindications to BCG.:

• if there are patients with tuberculosis among the contact child;
• if the mother has a HIV infection detected;
• diseases of the nervous system;
• any acute diseases;
• immunodeficiency; neoplasm;
• prematurity; body weight is less than 2.5 kg;

The diagnosis of the disease is the reaction of Mantu. This is not a vaccination that protects your child from the ill. This is an indicator that shows the baby or not.

Mantu sample put in the middle third of the forearm. Tuberculin is introduced, which is the filtrate of killed mycobacteria. It quarrels tuberculoprotein, which acts as an allergen. The drug is introduced intraderially, "citric crust" is formed at the place of administration.

The result is estimated not earlier than 48 hours:

• if a seal (papula) is formed at the injection site, the size of less than 5 mm is formed, this indicates a negative reaction;
• 5 mm-10mm - dubious reaction;
• if the size of the papula is more than 10 mm, then the reaction is considered positive and can be a sign of tuberculosis.

It is advisable not to wet after the vaccination "butt" after the vaccination and do not expose to friction.

It should be noted that the positive reaction of Mantu can be observed in healthy children within 1-2 years after BCG.

Contraindications for Mantu sample:

• hyperthermia;
• allergies in the aggravation stage;
• convulsions;
• skin diseases;
• quarantine.

Diagnosis and tests for tuberculosis

The diagnosis of the disease is aimed at identifying pathogenic bacteria in the media of the body, as well as in the target organs.

An early definition of the disease helps to cope with it as soon as possible with minimal damage to the body.

Diagnosis of tuberculosis in children is very rarely do without reaction manta. It is carried out annually, starting from 1 year old life. It allows you to identify the disease in the early stages of the disease. As well as those people who are carriers of this infection, but they themselves do not hurt.

To other research methods include:

1. Fluorography, radiography, tomography.
2. Bacteriological method. It consists in identifying the causative agent in various environments of the body. First of all, it is a sputum. As well as point from the pleural and abdominal cavities, joints, lymph nodes. For analysis can use the spinal fluid, the contents of the wounds and fistula, blood, urine. Modern method bacteriological research Is PCR diagnostics. This is a rather sensitive method. For him not enough a large number of bacteria. Suitable for the study of any body fluids. It is to identify DNA bacteria. This procedure is so accurate that allows you to identify the disease with the negative results of other tests.
3. Bronchoscopy.
4. Biopsy affected organ. Most often is carried out in diagnostic operations, when other methods are not much indicative. Most often it is a biopsy of lymph nodes, as well as pulmonary fabric when opening the chest.

Treatment

Treatment of tuberculosis in children pretty long. It is aimed at suppressing the development of tuberculosis sticks and restoring the affected organ.

The treatment of revealed tuberculosis in the hospital is beginning when bacteria are concentrated in extracellular space. The person is infectious.

1 stage of treatment - taking anti-tuberculosis drugs. These include: rifampicin, isoniazide, pyrazinamide, etcutol and others. They are the most efficient and least toxic. In the treatment regimen should be at least 3 such drugs. Also apply antibacterial therapy.

Also widely used physiotherapeutic treatment methods. With exudative and necrotic inflammation, UHF therapy, inhalation, electrophoresis are shown. In the future, ultrasound, magnetotherapy, laser for resorption of infiltrates, tissue restoration, wound healing are used.

Necessarily use immunostimulating drugs To increase the sustainability of the body in the fight against infection.

The patient must maintain the appropriate mode, balanced to eat, lead healthy image Life.

When the stage of the disease passes into a closed form, the treatment of tuberculosis house under the supervision of the phthisiart is allowed.

With the uselessness of conservative treatment surgical methods are used. It can be the removal of a part of the organ or affected area.

Tuberculosis treatment is a rather extensive process that requires patience and properly performing all its stages. It is complex, that is, affects the body from all sides by different paths. It must be remembered that the sooner the disease is identified, the easier and faster with it to cope.

Prevention of tuberculosis in children and adolescents

Prevention of tuberculosis for a child starts back in the maternity hospital with the first vaccination BCG.

Vaccination is important, and probably the most important stage in preventing the development of the disease. And you should not neglect them.

Improving the child's immunity - The second most important stage of prevention. Balanced, vitaminized food, hardening, correct operation and rest mode - pledge healthy Life kid.

Also in preventing the development of the disease plays early detection of infected people and their temporary insulationIn order to prevent infection of a healthy part of the population.

Tuberculosis is a rather complex disease, and, unfortunately, has high contagiousness. Every year the number of people infected with this ailment grows. That's why the prevention of tuberculosis is paid to much attention . After all, it is much better to strain immunity than to endanger the life of a child.

Tuberculosis is often called "social illness", explaining that the incidence of it is growing where everything is not safe with the living conditions.

With the worsening of the socio-economic situation and the growth of the number of asocial elements that are not passing medical examinations, big number People are ill, even more dangerous further infection. And traditionally in the risk group are the most defenseless.

Basic information

Tuberculosis - Disease of infectious origin caused chopsticks Koch (mycobacteriums). Tuberculosis wands were found to German scientists Robert Koh, who studied the disease, her symptoms and what provokes it in 1882.

Koh proved that the disease has an infectious origin. He found out high level survival of pathogens, their resistance to high and low temperatures, moisture, light and chemistry. With natural conditions, mycobacteria can live for several months, being covered from direct sun rayIn dust they live up to 10 days, in water - up to 5 months.

In addition to the resistance to adverse manifestations of the external environment, the reasons for which tuberculosis can not be defeated completely, the following:

• Bacillus Koch can live in the body for years, in no way showing itself, the beginning of the inflammatory process is completely unexpected.
• The first symptoms are similar to the symptoms.
• Mycobacteria are ability to mutate during the diseaseWhat is why they cannot be affected by antibiotics.

Because of the "survivability" of infections, tuberculosis is a very dangerous disease, the treatment of which is accompanied by large difficulties. Many patients are so fully and not get rid of this disease.

Causes of development, risk groups, danger

Infection of the body with koche sticks usually occurs when penetrating into the lungs airborne Path-made particles distinguished by coughing in a person with pulmonary tuberculosis.

Cause of infection in children - close contact with sick adults (relative). In addition to the aerogenic path, the body can get mycobacteria:

• an alimentary way (through the use of food from infected animals);
• contact path (sometimes infection with infection through the eye conjunctive);
• intrauterine infection (with an infected placenta or infection during childbirth).

The main reason for the development of tuberculosis in children - vulnerable immune system, weak due to young age or other reasons:

• genetic susceptibility;
• availability of chronic infections (as well as HIV and AIDS);
• constant stress;
• bad nutrition.

A high probability of infection in children from disadvantaged families and living in shelters or boarding schools.

Prerequisite acute gastritis In children - a strict diet. About her and many other things you will find out by clicking.

First and subsequent symptoms

In the early stages of the development of pulmonary tuberculosis in children, it exists very weakly, without obvious. Nonspecific symptoms - Income, chills, drowsiness and lethargy.

Sometimes specific signs are manifested:

• severe shortness of breath;
• no appetite, sharp weight loss;
• cough not passing over two weeks;
• wet excavation;
• abundant sweat at night;
• pain in the chest.

Detection methods: how to recognize

To identify tuberculosis in a timely manner in children both babies and preschool age complicated. And if babies still make vaccination in the maternity hospital, which allows the body to protect against full formation immune systemMakes the flow of primary illness as easy as possible, then with the kids of kindergarten age, everything is more complicated.

In preschool children Manifestations of tuberculosis at an early stage are non-specific: headache, overwork, lack of appetite, heat or chills - all this is usually accepted by parents for the beginning of ordinary flu. It is necessary to start to beat the alarm when anti-inflammatory and antipyretic drugs do not benefit.

Recognition at schoolchildren Simply, since they should be vaccinated every year. on the - The most effective method of detection of infection. Teenagers pass radiographic researchallowing you to "catch" the disease at an early stage. We wrote about other ways to diagnose tuberculosis in children.

At the first suspicion of the child you need to lead reception to the doctor's doctorwho will spend necessary examination, and when confirming suspicions will send to a specialist-phthisiatra.

It is important to remember: an open form of the disease in the absence of treatment leads to a fatal outcome of 50% of the illness in just one or two years.

What does Dr. Komarovsky say on this topic, look at the video:

Diagnostic events

Specific symptoms such as inflammation of lymph nodes, wheezing in the lungs, significantly increased temperature The child must make parents consult a doctor. During the examination specialist will collect anamnesis(family information, accommodation conditions, complaints, past illnesses) and assign tests for tuberculosis in children:

According to the results of the survey, the doctor will decide on the need and volumes of treatment.

How and what to treat

Chemotherapy- The fundamental method of combating tuberculosis in children and adults. It consists in receiving a patient a group of certain drugs in different combinations. This turns out to be a comprehensive effect on the Koch wand, invulnerable for ordinary antibiotics.

Preparations for treatment:

• Isoniazide;
• Pyrazinamide;
• Rifampicin;
• Etcutol.

From the listed medicines Compound combined schemes, at the same time effective and non-provoking mutation of drug-stable form of the disease.

Causes of their occurrence and what do doctors prescribe with the disease? All details are available and understood on our website.

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What to wait after treatment, prevention in kids and adolescents

Treatment of tuberculosis - the process is long and complex. Important not only strict adherence to the recommendations of the doctor and tough observance of drug reception schemes, but also the creation for a patient the corresponding situation for rehabilitation.

The recovering must be in a psychologically comfortable climate, get full-fledged foodtaking into account dietary constraints. The room where the restoration patient will live should be pure, ventilated, protected from viruses and infections.

What Tuberculosis Prevention Remedies recommended:

• regular reception of prescribed medicinal drugs, vaccination;
• periodic medical examinations;
• healthy lifestyle;
• optimal labor / training activities.

The forecast of the tuberculosis patient will be favorable in compliance with these conditions. One of them - accurate following the rules of prevention and rehabilitation. Reason has how timely a disease was revealed how effective therapeutic measures were.

Clinical recovery is considered healing of foci of inflammation and disappearance specific symptomsHowever, in places in localization of inflammation, "dormant" bacteria can be maintained that can provoke recurrence of tuberculosis.

Even with the most favorable outcome patients after recovery, stay on dispensary accounting With the need for regular survey.

Learn more about the disease more from a detailed video program:

Parents must closely monitor the state of the health of their children. Of course, you do not need to consider every "sneeze" deadly disease, but symptoms that do not disappear after the reception of the usual set of drugs should pay attention to. Although modern pharmacology allows you to successfully deal with tuberculosis, it still remains one of the most dangerous diseases in the world.

In contact with

Tuberculosis in children is a big problem in pediatric practice. Symptoms of tuberculosis in children do not have specificity. Signs of tuberculosis in children on each of the stages of the disease have their own coloring and manifestations. In children, includes vaccine-philaxcies and chemoprophylaxis.

With tuberculosis infection, the human body is most often found in childhood And in the subsequent never out of this meeting, without prejudice it does not come out. hidden in the organs of the reticulosendothelial system (system of macrophages) and in the future they can become the culprits of the disease. The interaction of the tuberculosis stick with the child's body is a rather complicated process. Symptoms of tuberculosis in children on each of the stages have their own coloring and manifestations.

(MBT) have complex metabolism, which ensures their variability and high resistance in the external environment and living organism. Under influence strong immunity (In this case, special cells of T-lymphocytes) and / or chemotherapy are converted into the L-form and coexist with the human body, without causing the disease. Tuberculosis sticks fall into the body of the child most often aerogenically, much less often with infected food products From sick animals and through the skin. In 50% of cases, patients with relatives become perpetrators of the development of tuberculosis in children. For a child, even short-term contact with a sick person is dangerous.

Fig. 1. Type of tuberculosis sticks in an electron microscope.

Fig. 2. Mycobacterium tuberculosis in a sputum preparation (electron diffraction pattern, negative contrast).

How does tuberculosis develop in children

The beginning of the interaction of mycobacterium tuberculosis with the child's body

Tuberculosis in children begins from the moment of entering the MBT in the nasopharynk, first in the mucous, and then into the submucoscent layer. The tuberculosis wand has lymphotropy, because of what quickly falls into the lymphatic system. Initially, in the sipstage lymphoid ring, which the child is very rich in a lymphoid cloth. Fagocites and tissue macrophages begin to fight the MBT. Swallowing mycobacteria and unable to destroy it, fighters with infection die (incomplete phagocytosis). Bacteria multiply and apply to a lymphatic system that is reported with blood flow. Infection, without having due removal, goes into the bloodstream (bacteremia).

The immune system receives a signal about the infectious agent and its cells (T-lymphocytes) begin to prepare for battle. The body begins to produce antibodies (produce and train T-lymphocytes), which goes about 2 months. It becomes positive for the first time in life. The clinic at that moment is determined by the number of pathogens. Symptoms of tuberculosis in children during this period are similar to those with ORZ. Than less childThe brighter the clinic of the disease, but never the body temperature will not be very high and the child will remain active.

General symptoms of tuberculosis in children during this period:

• insignificant body temperature increase
• nervousness and anxiety.

Local symptoms of tuberculosis in children during this period:

• the positive reaction of Mantu for the first time in life ("Virage" tuberculin samples).

Fig. 3. In the photo Tuberculosis in a child - the skin of the occipital part of the head and ear-sink is amazed.

What happens in the body of the child after the production of antibodies

After the production of antibodies, the MBT goes and fixed in the RES (the reticulondothelial system is the macrophage system). Scattered throughout the body (its cells are in the endothelium of the vessels of the liver, spleen, bone marrow), it leads to the child's body into a state of biological equilibrium, when the microorganism hid, but did not disappear. It is constrained by antibodies - trained T-lymphocytes (killers or "killers). They cut the bacterium in half, thus destroying it. The clinic at that moment is determined by the number of pathogens. Symptoms and signs of tuberculosis in children during this period are due to parapecific reactions (accumulation of certain cell groups in response to the introduction of MBT) and tuberculous intoxication. The child is subject to mandatory examination in a specialized institution and treatment.

How the disease is developing

If bacteria are not destroyed, then by the 6th month, single MBT begin to multiply and destroy tissues. The phenomena of intoxication in the child is growing. Around bacteria and caseosa (damaged tissue) shaped shaft from cells of a certain species (a tuberculous tubercle is formed). And further, by the 1st year, from the moment of the first meeting with tuberculosis infection, each MBT gives microcharosomes and microproralization (cell accumulation). MBT continues to multiply, the tubercles merge, local appears.

Symptoms of intoxication increase even more. An important feature of tuberculosis during this period is the presence of parapecific reactions. The foci of tuberculosis is most often appearing in intrathoramic lymph nodes and lungs. Tuberculosis in children is most often manifested by the lesion of intragenuous lymph nodes and lungs. With good outcome, the foci is cut off, but more often they germinate with fibrous cloth and calcined. If the calcination is incomplete and MBT not died, and turned into L-forms, then subsequent under adverse conditions they can cause a disease. The disease is prone to self-upfulness.

The Mantu reaction can be delivered in a different period of development of the tuberculosis process, which developed at the first meeting with the child's body. In all cases, the appearance of the first positive result, the child is sent to a consultation to the doctor of the phthisiatra.

Sometimes parents refuse to reaction by Mantu, ignore a visit medical institutionThe reduction in the weight of the child and the absence of appetite is explained by all sorts of reasons, but not only tuberculosis infection. Then the child is beginning to develop local forms of tuberculosis. To the doctor's physiology of such a child, parents will take place, but already with tuberculosis, which will require long-term treatment and recovery.

The medical network reveals a period of primary tuberculosis infection by the method of tuberculinidiagnostics (reaction of the Mantu reaction). When I detects "Virat" tuberculin reaction, the child immediately goes to a phthisiatra doctor who watches the child 1 year and, if necessary, assigns the necessary treatment.

If the child remains without adequate attention from the city, he can develop primary tuberculosis.

With a safe completion of the period of primary tuberculosis infection, the child will later be considered "not for the first time in life" with a life-positive reaction of Mantu.

• On average, in children from the 1st year to 12 years, the infection rate is 25-30% and then annually grows by 2.5%.
• In children 12 - 14 years, this figure is 40 - 60%.
• By the 30s, the adult population was already infected with 70%.

Fig. 4. Very often, the treatment of tuberculosis in children is carried out in the sanatoriums.

Symptoms of tuberculosis in children

Fig. 5. At the slightest suspicion of tuberculosis, the child is subject to consultation by a phthisiatra doctor.

Symptoms of tuberculosis in children do not have specificity. The clinical picture is made up of symptoms of intoxication, local symptoms and the presence of parapecific reactions. Symptoms of tuberculosis in children during the primary tuberculosis infection are due to parapecific reactions (accumulation of certain cell groups in response to the introduction of MBT), tuberculous intoxication and fever. Symptoms of tuberculosis in children during the development of local forms of tuberculosis depend on the volume of damage to tissues, the number of molten casease masses and the development of complications.

Common symptoms of tuberculosis in children

1. Symptom of intoxication

The symptoms of intoxication appear during the development period of the primary tuberculosis infection, when there are no visible focal lesions. They are varying degrees of severity and depend on the stage of the tuberculosis process. If the process of breeding MBT is underway, the symptoms of intoxication are expressed significantly. With the reverse development of the disease, the symptoms of intoxication begin to weaken and disappear at all.

The symptoms of intoxication include:

• worsening general well-being
• subfebrile body temperature,
• loss of appetite,
• weight loss,
• weakness,
• sweating
• loge in development, pallor of skin,
• neurovegetative disorders, which is manifested by sweating of palms and stop (distal dishydrosis), tachycardia, excitability or oppression, tachycardia.

Symptoms of intoxication in children appear gradually and do not have such severity as with ORVI.

2. Fever

Currently, typical fever is very rarely observed in children and adolescents.

Fig. 6. Permanent shaking, which develops into cough - signs of tuberculosis in a child. Cough indicates the defeat of the bronchi, which are always involved in the process in the development of lung tuberculosis.

3. The first signs of tuberculosis in children - parapecific reaction syndrome

Parapecific reactions occur during primary tuberculosis in children, when after the formation of antibodies, the MBT leaves blood to the RES authorities (the reticulorendothelial system is the system of macrophages). Her cells are in a variety of organism departments - lymph nodes, spleen, liver, in the walls blood vessels, connective tissue. Changes can be registered in the most different organs Child. They manifest themselves in the form of vasculitis, serososites, arthritis, erythema Nodozum and an increase in lymph nodes.

True paraspecific reactions are not tuberculosis inflammation, but the accumulation of certain cell groups in the above bodies in response to the introduction of MBT.

True parapecific reaction passes within 1.5 - 2 months. Tuberculosis is treated significantly longer. Very often, parapecific reactions appear when there are local forms of tuberculosis.

In children in the form of parapecific reactions are characterized by the following changes:

• From the side of the eye, the parapecific response is more often manifested in the form of blufaritis or conjunctivitis, or a combination of them. The parapecific reaction always flows rapidly, with tearing and light-in-friendly. The reaction of Mantu to children with such manifestations is not put. Previously need advice of the eyepiece.
• From the joints of the joints, the parapecific response flows under the arthritis mask.
• From the side of the skin, the parapecific reaction is manifested in the form of a ring-shaped erythema, which is localized most often on the skin of the front of the lower leg, less often - on the skin of hands, buttocks, ankle, ankle (area closer to the heel). Child should inspect everything!
• The reaction of the increase in lymph nodes is always present. Increased lymph nodes are painless and movable. There is always a group of lymph nodes, and not one lymph node. At the beginning of the process, they are a soft consistency, then elastic, with chronic flow of lymph nodes dense, like "pebbles".

Fig. 7. Parapecific reaction with tuberculosis - flossten.

Fig. 8. Paraspecific reaction with tuberculosis - keratoconjunctivitis.

Fig. 9. Parapecific reaction with tuberculosis - nodal erythema.

Fig. 10. Positive manta reaction.

Local symptoms of tuberculosis in children

Symptoms of tuberculosis in children with the development of local forms depend on the localization of the process of tissue damage, the number of molten casease masses and the development of complications. So tuberculosis in children flowing with the defeat of the bronchi will always be accompanied by a cough (minor passing to a strong cough).

• With the defeat of the pleura, the main symptom will be pain in the chest and shortness of breath.
• With kidney damage - dysuric phenomena and pain in the lumbar region.
• With damage to peripheral lymph nodes - swelling and painlessness.
• Under the defeat of the spine - a change in the behavior of a child, anxiety, a decrease in motor activity, pain in the spine and the appearance of deformation.
• With damage to the intestines - the phenomena of the disknesia of the intestine.
• With the damage to intra-painted lymph nodes - pain in the octopuspical region, poor appetite, periodic nausea and vomiting, unstable stool.

Morphology of tuberculosis process

Fig. 11. Multiple calcinates in pulmonary tissue with the reverse development of tuberculosis.

Tuberculosis in children is able to develop in any organ: lungs, bronchops, pleura, lymph nodes, kidneys, bones, joints, intestines, etc. And everywhere develops the same process - "cold" tuberculosis inflammation. It is based on the formation of granuloma ("tuberca"). More than 100 diseases, accompanied by the formation of granuloma, but only under tuberculosis in the center of each tuberca there are necrosis - tissue defeat.

When progressing the disease, the tubercles merge with each other, forming a fairly extensive destruction of fabrics in the center - curls of necrosis (dead tissue with tuberculosis looks like a soft white curl mass). After breakthrough, the casomic masses are formed cavity of the decay. With caseometric masses, there is a huge amount of MBT, which are settled in the tissues to be tissues, hitting them. The infection with blood flow and lymph begins to spread throughout the body, the Other organisms. With the reverse development of the disease, the foci and lymph nodes are compacted due to the hyalinosis (a type of modified protein resembling hyaline cartilage).

The affected surrounding tissues are transformed into fibrosis and cirrhosis. The cavity of the decay "closes", the scar tissue appears in their place. In areas of caseous necrosis, calcium salts are deposited.

Tuberculosis forms in children

Primary tuberculosis in children is developing during the first year from the moment of infection of MBT (primary infection). The shorter the period from the beginning of infection before the manifestation of tuberculosis, the worse the forecast. Having increased lymphotropy, MBT is most often affected by lymphatic nodes. Their defeat determines the entire clinical picture of the disease, the nature of complications and the time of cure. Paraspecific reactions during the appearance of local forms of tuberculosis are highly developed. The disease is prone to self-upfulness.

Tuberculosis intoxication

Tuberculosis intoxication appears during the development period of the primary tuberculosis infection, when there are no visible focal lesions. Gradually begins to deteriorate the general condition, the appetite worsens, the subfebrile body temperature appears in the evenings. Neurovegetative disorders are manifested by increased excitability or oppression, tachycardia and headache. The child is immediately subject to comprehensive examination At the physician doctor.

Fig. 12. Lack of appetite and weight loss - the first signs of tuberculosis in children.

Primary complex in lung

It is believed that with this form of tuberculosis of the MBT enter well ventilated areas of the pulmonary fabric. At the site of the introduction of bacteria, an inflammatory process is developing the size of a wicked grain. The focus is gradually increasing in size, and the mycobacteria in the lymphatic paths penetrate into intrathoracic lymph nodes, where caseaseous changes are developing. So the primary tuberculosis complex is formed. The primary tuberculosis complex in most cases is inclined to self-esteem.

Wide use and increased resistance of the body to infection in children today do not allow the heartbeat. According to the periphery of the focus, a fibrous capsule is formed, and in the very focus and lymph nodes, calcium salts are postponed. The disease is more often developing in non-vaccinated children and in children from the foci of tuberculosis infection.

Fig. 13. In the photo tuberculosis in a child - the outcome of the primary tuberculosis complex. On the radiograph, a single calcined center and calcinates are visible in the lymph nodes of the root of the left lung.

Tuberculosis of intragenic lymph nodes

92% of the entire children's tuberculosis is the defeat of intrathoretic lymph nodes. If several lymph nodes are hit, and the clinic with neuro-pronounced symptoms, they are talking about uncomplicated tuberculosis. The capsule of lymph nodes in the treatment is undergoing hyalineization, and in necrosis zones, the calcination process occurs. With complicated flow, the infection applies to neighboring lymph nodes and structures. Up to 70% of complications accounted for age from 0 to 3 years. Causes of this:

• imperfect system of anatomical structures (narrow bronchi, lack of cartilage),
• imperfect protection mechanisms
• unformed immune system.

The clinic is pronounced.

Fig. 14. In the photo tuberculosis in a child. Until the intragenous lymph nodes. On the radiograph of the lungs in the root of the right light, increased lymph nodes are visible.

Fig. 15. On the radiograph of the lungs, enlarged lymph nodes in the roots of the lungs.

Fig. 16. A group of calcined lymph nodes is visible on the radiograph from 2 sides.

Tuberculosis bronchi

Infection in bronchus gets from lymph nods through intermediate fabric. The intermediate fabric in childhood is not perfect. It does not fully fulfill its protective function (does not hold the infection). Most often great bronets and bronons of the 1st, 2nd and 3rd order are affected. In the development of the disease, violations appear bronchial Penthood With the advent of hypoventilation sites, up to the development of atelectasis (pulmonary flip). Very quickly in these areas arises nonspecific inflammation. If the portion of the atelectasis is infected with MBT, then a formidable complication arises - caseometric pneumonia, which causes a fatal outcome in 40% of cases.

Caseous pneumonia over time can be transformed into fibrous-cavernous tuberculosis. At best, under the influence of the development of the cirrhosis, the atelectasis section turns into fibrous litter. If during the week it is not to restore the permeability of the bronchi, then the airiness of the affected section of the pulmonary fabric is no longer recovered and the child remains disabled for life.

Fig. 17. In the photo Tuberculosis in the child. Bronths are amazed. On the radiograph of the image of the atelectasis: the upper share of the right lung has burned and decreased in volume.

Pulmonary tuberculosis

In the pulmonary tissue there are lesions from single foci (focal tuberculosis) before the spread of infection in all the pulmonary fields (disseminated tuberculosis). The clinic of the disease depends on the area of \u200b\u200blesion of pulmonary fabric, bronchi and pleura. In the pulmonary fabric, areas of decay (decay cavity) can appear.

Fig. 18. In the photo of tuberculosis in a child. Acute form Disseminated lung tuberculosis.

Tuberculous Purrites

When driving infections in Plevra, a tuberculous pleurite occurs, which is up to 70% of all children's pleurisites. Often, paying pleural cavity Minor and clinically manifests poorly. Practically does not occur in children up to 2 years. Very rarely found in children from 2 to 6 years. With significant population, elevated temperatures, chest pain and shortness of breath appear. The forecast is favorable.

Purgeless forms of tuberculosis in children

As a rule, the disease occurs in the spread of infection on lymphatic paths or with blood flow. The process develops as a result of a sharp impact of immunity, poor-quality vaccination or its absence, adverse living conditions and related diseases.

Tuberculosis Meningitis

It occurs in the absence of vaccination against tuberculosis at the birth of a child. Currently, the disease is extremely rare.

Tuberculosis of the bone-articular system

Systems are always combined with lung damage. It is characterized by the lesion of the sprout cartilage and extensive changes in the affected joints and the spine. The disease is accompanied by the advent of abscesses, purulent racks and fistulas and is often complicated by paralymps that arise as a result of compression. spinal cord Destroyed vertebrae or abscesses. In the past 10 years, complications began to appear after vaccination in the form of limited bone lesions.

Fig. 19. In the photo Tuberculosis in the child. On radiographic lumbar Department The spine red circle shows typical damage to the bodies of vertebrae tuberculosis.

Fig. 20. In the photo Tuberculosis in a child. In the photo of the tuberculosis of the right hip joint of the patient for 11 years. The head of the hip bone is completely destroyed.

Fig. 21. Tuberculosis Trochetterite. Extensive destruction of a large skeleton of femoral bone.

Fig. 22. In the photo Tuberculosis in a child. The patient spares the leg and shrieks the pelvis.

Fig. 23. In the photo tuberculosis in a child. The spine is amazed at the child for 9 years. The picture shows almost destroyed vertebral bodies. Kyphosis.

Fig. 24. In the photo of the tuberculosis of the spine (side view).

Fig. 25. In the photo of the tuberculosis of the spine (rear view).

Fig. 26. In the photo Tuberculosis in a child - tubular bone diaphysis tuberculosis (Spina Ventosa Tuberculosa). The disease is more common in childhood. Short tubular bones of hands and stop brushes are affected. Less often long tubular bones.

Tuberculosis kidney

It is up to 50% of all forms of extrapulic tuberculosis. The kidney infection penetrates the blood flow during the primary tuberculosis infection. Initially, the brain layer is amazed, where the cavities and decay foci are formed. Next, the process goes to cups and lohanks, bladder and ureters. When healing, a large number of scars are formed.

Fig. 27. In the photo tuberculosis in a child. Amazed left kidney. Cavenna is visible in the upper pole.

Tuberculosis Peripheral Lymph nodes

The disease is more often caused by a bull-type mycobacterium. The cervical (83% of cases) is affected, submandibular, axillary lymph nodes (11%), inguinal (5%).

Fig. 28. In the photo of tuberculosis in a child. The submandibular lymph nodes are affected.

Abdominal tuberculosis

Observed very rarely. Tuberculosis is striking the intestines, intra-abdominal lymph nodes and a serous shell.

Fig. 29. In the photo the consequences of tuberculosis in a child. Changes are visible on the skin after curing the tuberculosis submandibular lymph nodes.

Mantu reaction - the method of early detection of tuberculosis

Today, tuberculinidiagnosis is the only method of detecting tuberculosis in children at an early stage. Tuberculin is a drug that is manufactured from the cultures of filtrates of tuberculosis sticks or from the pathogens themselves. Being an incomplete antigen (Hapten), he calls only a response allergic reaction. Sensitize the body of the life of pathogens. Allergens are sensitized T-lymphocytes. They are located in organs and tissues. So it take time to complete a full-fledged reaction. Phase, during which Papula is formed, take 72 hours.

Mass tuberculinidiagnostics conducts a common therapeutic network. Her task is as follows:

1. Remove persons infected with tuberculosis.
2. Identify a risk group with a "vioration" of tuberculin reactions.
3. Select faces for vaccination.
4. Remove changes in the nature of the Mantu reaction.

Individual tuberculinidiagnostics are carried out by persons consisting of a tuberculosis dispensary.

Fig. 30. In the photo medical worker Enters tuberculin.

Fig. 31. In the photo, the reaction of Mantu. Papula measure 72 hours after the administration of tuberculin.

Tuberculosis, being a dangerous infectious disease, in the near past was considered incurable. Millions of people were dying every year. Mandatory vaccination of children and the presence of effective drugs helped doctors control the infection.

The main measure of the prevention of tuberculosis is the vaccine-philament and chemoprophylaxis.

BCG vaccination - the basis of the prevention of tuberculosis in children

Anti-tuberculosis vaccination is the main component in the fight against children's tuberculosis in the Russian Federation. 64 World Countries Currently made vaccination with a mandatory component in the preparation of the development of tuberculosis. For the first time in 1919, the French scientist A. Calmett and Sh. Genre created the BCG strain, which was used to vaccinate people. In 1921, the first child was vaccinated.

• Prepare a vaccine from the strain of alive and weakened mycobacteria tuberculosis, which almost lost its damaging property.
• The vaccine is introduced intradermally into the upper third of the shoulder and causes the body to produce antibodies.
• The effect of the vaccine is weakening by the 4th year.
• The first vaccination is carried out in the hospital for 3 - 7 days from the birth of a child.

If for any reason the vaccine in the maternity hospital was not introduced, vaccination will be carried out in the clinic. Second vaccination is carried out for children of 7 years (first graders). Full immunity is formed during the year. On the creation of immunity, the rutter formed as a result of vaccination. It is fully formed by 9 - 12 months.

• If the size of the scar of 5 is 8 mm, then a tuberculosis protection index from 93 to 95%.
• If the Rubber 2 is 4 mm, then the protection index is reduced to 74%.
• If the Rubber is 10 mm and deformed, then it says that complications arose with the introduction of vaccine and immunity did not work out.

The vaccine prevents the development of meningitis and miliar tuberculosis, that is, those forms of tuberculosis that apply with blood. The frequency of complications from vaccination is 0.1%. Complications are manifested in the form of cold abscesses, surface Yazv, BCG-ITOs (regional lymphadenitis, saving, conjunctivitis), keloid scars. The generalized BCG infection is very rarely developed.

Fig. 32. Conducting vaccination in the hospital.

Fig. 33. Conducting vaccination in the clinic.

Fig. 34. Measurement scuffs after the BCG vaccination.

Fig. 35. In the photo complication of BCG. - Surface ulcer.

Fig. 36. In the photo complication of BCG - axillary lymphadenitis.

Fig. 37. In the photo complication of the BCG - a keloid scar after vaccination.

Fig. 38. In the photo complication of BCG - ulcerative-necrotic tuberculosis of the skin after vaccination.

Prevention of tuberculosis in children

1. The main measure of the prevention of tuberculosis is the vaccine-philantal.
2. Strong dispensary observation and the treatment of children of their foci tuberculosis infection.
3. Increase parental responsibility for children's health.
4. Formation in children of a healthy lifestyle.

Tuberculosis in children is a rather dangerous disease. Parents should know that the rejection of the vaccination from tuberculosis deprives the child to protect against infection!

Tuberculosis in children today is an urgent problem. The source of infection for children is almost always adults, the incidence of which is currently in Russian Federation still very great. Despite the fact that the symptoms of tuberculosis in children and the first signs of the disease do not have specificity, parents should always be alerted with the emergence of intoxication and subfebrile body temperature in a child, a decrease in appetite and weight loss. Prevention of tuberculosis in children is one of the main components of the work of Russian health care. And parents must be responsible for the health of children and form a healthy lifestyle they have.

Articles section "Tuberculosis"Most popular 798 03/08/2019 6 min.

Symptoms of tuberculosis in childhood are manifested faster than adults. This is associated with the structure of the body and the pulmonary system.

Children's tuberculosis can be associated not only with the operation of the pulmonary system, but also with degrading processes in the brain area, skeleton, and so on. Symptoms will differ.

If the disease reveal as early as possible, it is good to treat. Otherwise, it may be incurable. But most often tuberculosis begins and proceeds in the early stages unnoticed.

In that article, we will tell you about the reasons for the occurrence of tuberculosis in children, about his symptoms, possible complications and on prevention methods.

Determination of the disease

Tuberculosis is infectionCaused by mycobacterium tuberculosis or koche. In childhood, it is worn much harder than in adult. Due to the end of the immunity formed, the child's body is difficult to respond to the correct response to infection and localize it in one area.

An extensive defeat of the authorities leads to irreversible consequences, which is why it is necessary to diagnose the disease as early as possible and begin its treatment.

Preschoolers often have defeats not only lungs, but also other organs. At this age, such forms such as tuberculous meningitis, primary tuberculosis complex and miliar tuberculosis are often diagnosed. In this case, the main causes of the disease are contacts with infected people and the absence of BCG vaccination.

• Tuberculosis meningit is striking the brain shell. In children, he quickly progresses. The disease is accompanied by a headache, a systematic increase in temperature, lethargy, frequent change of mood. With this form of tuberculosis, individual sections of the brain are affected, which are responsible for various functions.
• The primary tuberculosis complex is accompanied by a high temperature (up to forty degrees), cough and pain in the lungs, wheezes, loss of appetite, weakness. For diagnosis, a manta test is necessary and the pulmonary x-ray.
• Miliary tuberculosis It is an extensive lesion with tuberculosis bubbles. It has an acute course, strikes the spleen, kidneys, breathing organs. Miliary tuberculosis is divided into two types:
  1. Acute tuberculosis sepsis. The symptoms are quite blurred, so it is very difficult to diagnose, and the child can die.
  2. Acute miliar tuberculosis. On the initial stages It is limited, and then develops into extensive.

Also tuberculosis is pulmonary and extractive. In the first case, he is divided into, and cavernous. Types of extrapulic tuberculosis: tuberculosis of bones and joints, leather, organs of vision, organs gOOD SYSTEM, CNS, stomach.

Depending on the flow of tuberculosis, it happens open and closed. With the open form of mycobacteria, enter the environment through the highlighted sputum. With a closed form, the possibility of infection of the surrounding people is missing.

It is worth noting that children suffer from manifestations of tuberculosis to a lesser extent. They prevail light shapes that affect only small areas of affected organs.

Causes of occurrence

The main cause of tuberculosis is a tuberculosis mycobacterium or koche.

Almost all children are infected with this bacterium, but in most often the koche sticks are low-active, so immunity is able to cope with them. But if the child does not eat well, he is often overwhelmed, lives in bad conditions, then mycobacteria can be activated and caused the disease. These factors are the risk factors for infection and the development of tuberculosis.

In children under two years, immediately after infection, the massive distribution of infection is possible. At the older age, immunity has time to localize infection at the lungs level, so they most often develop pulmonary tuberculosis.

There are several ways to hit mycobacterium tuberculosis in children's organism:

1. Cognital path. The child's infection occurs in the womb. But this path of infection is extremely rare. Most often, mycobacteria attack the baby already during the extra utilization life.
2. Aerogenic path. This is the most frequent path of infection. In this case, mycobacteria or through dust, on which sputum particles isolated with patients can be seen. If someone is sick in the family with tuberculosis, the likelihood of infection of the child reaches eighty percent.
3. Through food. Mycobacterium tuberculosis can fall into a children's body through milk infected cows. Currently, such a way of infection occurs in fifteen percent of cases of infection.

Symptoms

Symptoms of tuberculosis in babies:

• Weakness, lethargy, small mobility, apathy.
• Periodic attacks of choking, strong cough.
• Burst of one of the pieces of the chest.
• Reduced actual and muscle weight.

Tuberculosis in such kids is very dangerous because it is later identified. As a result, the possibility of early start of treatment is lost.

up to five to eight years:

• Deterioration of well-being, weakness, decrease in physical activity.
• Loss of appetite, bad sleep.
• Weight loss.
• Cough.
• Flipping one of the pieces of the chest.

At this age, the symptoms are more pronounced. Children of five to eight years can already explain words that they are worried about what signs of the disease they feel.

Symptoms of tuberculosis in children from eight to fourteen years:

• Strong weakness and apathy.
• Painful sensations in the field of lungs.
• Active cough urges passing into permanent.
• Dyspnea even at rest.
• Flipping or spare one part of the chest.
• Changing the color of the skin, thinning of the epidermis, the appearance of the wound and cracks.
• Changing the size of lymph nodes.
• Forced hemoptia.

The following symptoms of tuberculosis in adolescence are manifested in the pathological problems of the body or late treatment. There is a hemoptia at the last stage of the development of the disease. The strongest painful sensations are formed. Mortulate and cervical lymph nodes change.

Symptoms of intoxication in adolescence:

• It is impossible to eat food, as it is not perceived by the body.
• Permanent cough accompanied by painful sensations And hemochkit.
• There is a loss of hearing, the smell due to the fact that tuberculosis or intestinal chopstick is actively developing.

Possible complications

Easy tuberculosis is a disease that may cause serious complications. They negatively affect the work of the heart, liver, kidneys, they can destroy the skeleton, bone tissue.

In childhood, pain in the field of heart can appear due to tuberculosis, itching in limbs, tachycardia, joint pain. Complications are characterized by a long and heavilyThey develop quickly and proceed painfully. In order to determine the localization of the lesion, a special test and full prevention is needed.

Violation of the hormonal system of the body is a specific complication of tuberculosis. It is accompanied by a worsening of well-being, an increase in weight, attacks of aggression and change of behavior.

Diagnostics

To prevent the development of complications, diagnosis and prevention of children up to sixteen years are needed.

Diagnosis includes:

1. Studying the history of the child's disease.
2. Physical inspection to identify features and changes in the structure of the chest, as well as the character of wheezing and cough.
3. Instrumental examination: ultrasound, fluorography, x-ray.

It is worth noting that the treatment of tuberculosis in children is carried out by the same drugs that are used for. Usually, children normally tolerate therapy, resulting in damaged lungs are restored.

Prevention

Prevention of tuberculosis in childhood has two directions:

• Prevention of tuberculosis in children who did not have contact with patients.
• Prevention of tuberculosis in children who were in contact with patients.

In the first case, prophylaxis is aimed at vaccination. The BCG vaccine is represented by a bull-type weakened by mycobacteriums, which in their structure are very similar to the pathogens of tuberculosis. It is introduced intradermally for five centimeters below the top of the shoulder. Thanks to vaccination, protective immunity against tuberculosis is created.

There are a number of contraindications for vaccination. The vaccine cannot be administered to children, in which there are cases of immunodeficiency, as well as severe complications that arose after vaccination in relatives. Can not be vaccinated if there is no enzyme or not enough if there is heavy genetic diseases, lesions of the central nervous system.

In the second case, prevention begins with the establishment of possible signs of the disease, after which the course is assigned preventive treatment (It uses a preparation of five milligram per kilogram of weight for six months).

Video

This video will tell about the symptoms of tuberculosis in children.

conclusions

To identify cases of infection with tuberculosis, all children are sampled by Mantu every year. It is harmless, since there are no viable myobacteria in its composition.

Parents must protect the child from this serious illness and its severe consequences. For this, sufficiently systematic control over the well-being of the child, as well as vaccination. Need to try to prevent the development of tuberculosis than later for a long time Treat him.

Cannot be engaged in the self-treatment of tuberculosis. When manifesting any symptoms of the disease, you need to contact the phthisiatra as soon as possible.

In addition to the species described, it is worth paying attention to such forms of tuberculosis, as, and.

The children's body is vulnerable to various aids, which can be overtaken in every minute, one of these is tuberculosis. With a timely identified symptoms and assistance rendered, the immune system will be able to cope with the disease without any problems. Infection is most often occurring by contacting patients. The first confirmations of the existence of the pathogenic bacterium were still in late XVIII century R.KOhOh, from where and got its name.

Most often, Koch bacterium is dangerous for children who have weakened protective functions Immune system, suffering from malnutrition and lack of sleep, with insufficiently obtaining vitamins. What is characteristic, no chance can recur and sink.

The most common test on the detection of tuberculosis infection is sample mantuwhich quarterly spend children in school institutions. But, parents should not panic if the reaction to tuberculin sample revealed positive. This result is not yet evidence that the child is sick with tuberculosis. A positive reaction may confirm the absence of a tuberculosis infection body resistance. Therefore, in the future you need more vigilant control over the state of health.

Penetration of the pathoral stick in the children's body occurs in several ways. More than 90% of children who are ill with tuberculosis were infected by the air-droplet. In other cases, the infection occurred with direct contact with the carrier of the ailment or with its things (through dishes, clothes, toys). also in medical practice It was noted that the infection may occur still on the intrauterine level, but infection is thus found extremely rarely.

But, the highest risk when the Bacillus separator lives with a child on one territory. The most critical age when infection with a tuberculosis stick can lead to the most terrible consequences - is the teenage, when the body's complete restructuring, newborn and early up to three years occurs.

Which is characteristic, after infection, the disease does not manifest itself immediately, and may be located for several months and, even years, in incubation period. The initial stages are also not different from the visible symptomatics, so the diagnosis of children's tuberculosis with multivariate clinical paintings is extremely difficult.

Classification of children's tuberculosis

Several species that affect the child's body are distinguished:

1. Tuberculosis inxication of primary character.
2. Tuberculous illness of respiratory organs.
3. Tuberculous illness of other organs.

In turn, tuberculosis intoxication may be early as well as chronic. Small children most often suffer from primary tuberculosis. For newborns and infants, the danger represent miliar and meningitis forms. For older children are characterized by fuboxication, but with favorable forecasts on recovery.

Symptomatics of tuberculosis in children

Signs of the disease are little specific, but despite this, they can still attract the attention of parents. TO primary symptoms Believe:

1. Excessive fatigue without unnecessary physical exertion.
2. Increased irritability.
3. Lack of normal appetite.
4. Violations of normal sleep.
5. The child becomes a larger and silent.
6. The skin acquires an unhealthy look and becomes pale.
7. Headaches are rapidly.
8. Weight loss are possible.
9. Periodic change in temperature indicators (boost to 37.5 c).
10. When palpation feels an increase in lymph nodes.
11. Allergic manifestations are possible.

If we talk about symptoms, which confirms chronic course of illness, it should be noted such signs:

1. There is a late physical development.
2. The child begins to lose weight.
3. The level of sweating increases.
4. Increased minor temperature For a long time.
5. The child begins to feel frequent malaise.
6. The pallor of the skin with the peeling cheeks.
7. Eyes are characterized by glass glitter.
8. When feeling you can notice an enlarged liver.

It is clearly visualized that it is a children's tuberculosis in a video, which presents a brief information about the manifestations of Koch sticks in children and comments from specialists in this regard.

Note! An independent diagnosis of tuberculosis in a child will not lead to anything good, because the above symptoms is not an accurate confirmation of infection. The diagnosis is made exclusively after X-ray respiratory organs and detailed blood test.

Video - Children's tuberculosis

Clinical form of manifestation

If the test of manta gave positive result, then the disease itself, if it proceeds in chronic form, can only manifest itself in six months or even a year later. To understand the danger of the disease, you should familiarize yourself with all possible clinical forms.

The area of \u200b\u200blesion	a brief description of
Tuberculous lesion of joints and bones	This form of illness is characterized by quite slow development. Most often, lesion is localized in the spine area, knee joints, hip joints. Among the characteristic symptoms can be selected. Additionally, the child may complain about the diseases of the movements
Tuberculous lesion of pulmonary fabrics	Infectness of children's lungs occurs much less frequently. It is characterized by a clear long-term increase in temperature, which does not pass on its own. Therapy of such a form of manifestation is difficult, but complete cure is possible. The danger of pulmonary tuberculosis is for very small children and with late detection of the decay of the pulmonary fabric and the defeat of the rest of the organs
Tuberculous lesion of bronchial glands	It is considered the most common form of the disease among children. If the pathoral stick is hit, it forms a focus of tuberculosis inflammation. Manifestations occur in two ways: 1. It occurs as influenza with characteristic symptoms and is accompanied by a long cougium with a protracted elevated temperature. 2. It may occur in a hidden form and manifest itself in the form of changes in behavior: the child becomes more capricious, quickly tires, cough arises
Tuberculosis lesion of lymphatic nodes	The very first and obvious sign is highly enlarged lymph nodes. Over time, the lesion process leads to the infusion of lymph nodes, even fistulas may form
Tuberculous lesion of brain shells	Meningitis for medical statistics is most often among children than adults. The disease can develop for three weeks and only after this time appears clear symptoms: 1. The child becomes very restless. 2. There is no appetite. 3. Lost arises. 4. Total temperature. 5. Vomiting. 6. Sometimes even cramps

Reference! A sufficiently long period, experts were powerless before the manifestations of the tuberculosis of the cerebral shells, therefore most cases had adverse predictions and even fatal outcomes. Today, medicine has significantly advanced and can eliminate this species Diseases by applying special antibacterial therapy, which refers to the new generation.

How is the diagnosis and treatment of children's tuberculosis, you can learn from the video, where the specialist gives a detailed comment on the course and treatment of illness.

Video - diagnosis and treatment of tuberculosis in children

How to Prevent Infection: Preventive Events

To carry out the prevention of tuberculosis, special living pathogenic microorganisms apply. To hit the children's body to fully microbes cannot, because they are weakened. Revaccination is recommended in adolescence, since during this period protective functions are very weakened, due to the restructuring of the body. Also required a secreting course. Parents need:

1. Monitor the correctness of the diet so that it is vitamined and balanced.
2. The child must regularly walk outdoer.
3. We need planned preventive vaccinations.
4. Be sure to make samples Mantu and with a positive reaction to observe the health of the child throughout the year.
5. Do not miss planned fluorography.

Attention! In preventive purposes in the maternity department, the BCG vaccination is performed. It prevents the infection of the newborn tuberculosis stick.

What to do if in the family has bacillos sequencer?

In order to prevent the infection of other family members, in particular the child, it is necessary to urgently contact the phthisiatra, which will conduct a survey and special chemoprophylaxis. Preventive measures in families infected include the following points:

1. All the necessary utensils for the patient should be extremely individual and stored in a separate remote location.
2. Processing of dishes should be made by special means.
3. The patient needs to have individual bedding, towels.
4. In the room it is necessary to spend special wet cleaning every day.
5. The patient should have a pumel.
6. On the fact of hospitalization or fatal outcome The patient should be caused by the sanitary and epidemiological service for disinfection of the entire residential area.