Tuberculosis, BCG

Tuberculosis, BCG

Tuberculosis intoxication (as a form of tuberculosis in children and adolescents). Increased fatigue, irritability, headache, loss of appetite, poor weight gain or deficiency, intermittent low-grade fever. Enlarged peripheral lymph nodes of elastic or dense consistency; sometimes the phenomenon of periadenitis.

Many children have bronchitis, tachycardia, and in young children - dyspeptic disorders, abdominal pain, and sometimes enlargement of the liver and spleen. There is a change in sensitivity to tuberculin using the Mantoux test or hyperergic reactions to tuberculin. The Mantoux test is persistently positive, and its intensity often increases.

In the blood - lymphocytosis, eosinophilia, increased ESR. The protein fraction of albumin is reduced, globulins and fibrinogen are increased. X-ray examination of the lungs reveals an increased vascular pattern.

Outcome: recovery, transition to local forms of tuberculosis. It is necessary to differentiate from chronic tonsillitis, sinusitis, latent rheumatism, chronic cholecystitis, pyelonephritis, chronic eating disorders and digestion.

Primary tuberculosis complex. The onset of the disease can be acute, subacute, sometimes occurs under the guise of acute pneumonia, influenza, pleurisy, or can be asymptomatic. The nature of the temperature reaction and its duration are different. The child’s well-being suffers little; severe symptoms of intoxication, cough, and shortness of breath are rarely observed.

Physical data are usually sparse. Sometimes there is a noticeable shortening of the percussion sound, slightly weakened or harsh breathing in this area. Dry and moist rales are heard less frequently.

In the blood - leukocytosis, moderate neutrophilia, increased ESR, when the process subsides - eosinophilia and lymphocytosis. The Mantoux test is positive; the graduated skin test can be equalizing or paradoxical. X-ray reveals a darkening that is not completely homogeneous, connected by a “path” to the root of the lungs, or bipolarity.

Often the primary complex is complicated by pleurisy, less often limited hematogenous or lymphohematogenous dissemination appears, usually on the affected side. There is an infiltrative phase, which gradually passes. in the phase of compaction and resorption. This is followed by the petrification phase. It is necessary to differentiate from acute and chronic nonspecific pneumonia.

Tuberculous bronhadenitis is more common than primary tuberculosis complex. Clinical manifestations depend on the degree of damage and the extent of the process in the lymph nodes and the root of the lung. Conventionally, a distinction is made between infiltrative and tumor-like (tumorous) bronchadenitis. The latter occurs in young children, sometimes in adolescents.

The onset of the disease is usually subacute. General symptoms of tuberculosis intoxication and fever are noted. Bronhadenitis quite often occurs asymptomatically or with few symptoms. In the infiltrative form of bronchidenitis, there are no percussion and auscultatory symptoms; they occur only in severe forms of tumorous bronchadenitis.

In the presence of symptoms of compression, expiratory stridor, bitonic and whooping cough are observed. Expansion of the capillary network in the area of ​​the VII cervical and I thoracic vertebrae (Frank's symptom) or expansion of the saphenous veins in the upper chest and back. Shortening of percussion sound in the paravertebral region, usually on one side. Sometimes Koranya's sign is positive. In the area of ​​shortening of the percussion sound, breathing is weakened or harsh. Dry wheezing is heard less frequently and the dEspina symptom is detected.

X-ray reveals an increase in the size of the lung root, the shadow of the root is less differentiated, the border is aligned outward, indistinct, vague. With tuberculous bronchaditis, an isolated shadow is found inside