Diagnosis of Tuberculosis

Tuberculosis (TB) is one of the 10 most frequent causes of death in the world. Worldwide, it remains the top infectious killer, with 10 million people falling ill with TB in 2018. Tuberculosis in childhood has specific connotations that differentiate it from that of adult cases. Suspicion of tuberculosis in this category of patients may be related to clinical suspicion as well as suspected epidemiological and social suspicion. The spectrum of childhood TB varies wildly, from infection to a lung parenchymal focus (Ghon focus) with or without mediastinal lymphoadenopathy.   

In addition, TB in childhood has some peculiarities: increased risk of progression from infection to disease equal to 40% in the first year of life, faster course of the disease, more prone to extrapulmonar TB including disseminated forms (miliary and tuberculous TB) and paucibacillary disease (low number of bacilli).

It’s important to know the various immunologic mechanisms which modulate individual ability to fight infection, taking into account the major host and pathogen determinants in the susceptibility to tuberculosis. Macrophages and T lymphocytes, together with granuloma formation, are the pillars of immune defense against Mtb, but however, there is no component of the immune system that does not take part in the response to this pathogen.

TB diagnosis in children is traditionally based on the tuberculin skin test (TST), chest radiography, and microbiological testing.

Dr. Paolo Toma
Dr. Laura Lancella
Guest Editors

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