Tuberculosis (TB) in Children: Signs, Symptoms, and Treatment

TB is a severe infectious disease also termed "tuberculosis." The bacterium Mycobacterium tuberculosis causes it, and initially affects the lungs but can also spread to other parts of the patient's body. Best child specialist doctor in Delhi shares- TB has long been known as an adult disease. But it can also occur in children, certainly in areas where TB is common. 

It is necessary to recognize its signs and symptoms in children, as initial treatment can prevent the progression to severe complications

Signs and Symptoms of TB in Children

Children infected with TB often exhibit multiple symptoms, some of which may be mistaken for other common illnesses, such as pneumonia or bronchitis.The symptoms usually develop gradually and may remain unnoticed initially.

, hence making early diagnosis of TB is challenging. 

The most common signs and symptoms of TB in children are:

1. Chronic Cough: A persistent cough is one of the most common symptoms of TB. If someone is experiencing a persistent cough that lasts for more than 2 weeks, then they must seek immediate medical attention. The cough may be dry or develop mucus. In severe cases, the patient may experience coughing up blood.

2. Fever: Patients with TB may develop a low-grade fever that worsens as the disease progresses. This fever may worsen in the late afternoon or evening.

3. Weight Loss: Unexplained weight loss or failure to gain weight is a significant symptom in children with TB. This is often linked with a loss of appetite and general malaise.

4. Night Sweats: Patients may experience excessive sweating during the night, a common symptom of TB in both adults and children.

5. Fatigue and Weakness: Children with TB may experience a sense of tiredness, weakness, and lethargy, even with low physical activity.

6. Shortness of Breath: If TB has progressed to the lungs, children may experience difficulty breathing, chest pain, and wheezing.

7. Swollen Lymph Nodes: TB can cause lymphadenitis, resulting in swollen and tender lymph nodes, particularly in the neck and armpits.

8. Gastrointestinal Symptoms: In some cases, TB can affect the abdomen, causing nausea, vomiting, and abdominal pain. Children may also experience diarrhea or constipation.

9. Irritability: In younger children, TB may cause irritability and behavioral changes, as they may not be able to articulate their feelings.

In infants and very young children, symptoms may be more subtle. A persistent cough, poor feeding, and failure to thrive are often the first signs of TB in this age group. Parents and caregivers must be vigilant if their child has been in contact with someone diagnosed with TB or is living in an area with a high incidence of TB.

Diagnosis of TB in Children

Diagnosing TB in children can be more difficult than in adults, as children are less likely to have positive sputum samples or a clear chest X-ray. Some of the primary diagnostic tests for TB in children, as per a General Pediatrician Doctor in Delhi:

• Tuberculin Skin Test (TST): A small amount of purified protein derivative is injected under the skin. If the child has been exposed to the TB bacteria, the skin will react with a raised bump

• Chest X-ray: A chest X-ray is crucial for visualizing lung abnormalities that may be caused by TB, such as lung infiltrates or cavities

• Sputum Smear and Culture: While sputum samples can be collected from older children who can cough, younger children may need to provide samples via gastric aspiration (where a sample is taken from the stomach)

• Molecular Tests: Molecular tests can help detect the TB bacteria in sputum or other fluids more rapidly

• Lymph Node Biopsy: In cases where TB affects the lymph nodes, a biopsy may be needed to confirm the diagnosis.

Treatment of TB in Children

Treating TB in children is crucial to prevent long-term complications, spread of the disease, and death. The treatment for TB involves a combination of several antibiotics, taken over an extended period, typically six to nine months. The goal is to completely eradicate the bacteria while minimizing the risk of drug resistance. The standard regimen for treating pediatric TB includes:

1. First-line Antibiotics: The most commonly prescribed drugs for TB in children are:

• Isoniazid (INH)

• Rifampin (RIF)

• Pyrazinamide (PZA)

• Ethambutol (EMB)

These drugs are typically given in combination for the first two months, followed by a continuation phase with just isoniazid and rifampin for the remaining four to seven months.

1. Directly Observed Treatment (DOT): Adherence to the treatment regimen is vital to prevent the development of drug-resistant TB. In some cases, healthcare workers or trained caregivers will observe the child taking their medication to ensure that the treatment is completed properly.

2. B Vitamin Supplementation: Some TB medications, particularly Isoniazid, can cause a deficiency in B vitamins, so children undergoing TB treatment may be given vitamin B6 supplements.

3. Nutrition: Proper nutrition plays an essential role in helping children recover from TB. Ensuring that the child is consuming enough calories, proteins, and vitamins will support their immune system and overall health.

4. Isolation and Preventing Transmission: Children diagnosed with active TB should be isolated until they are no longer contagious. This can reduce the risk of spreading the infection to others, especially in a family or school setting.

Preventing TB in Children

Preventing TB in children involves several strategies:

• BCG Vaccination: The Bacillus Calmette-Guérin (BCG) vaccine is a preventive measure against TB. It is commonly administered to infants in countries with high TB incidence and provides some protection against severe forms of TB, such as TB meningitis.

• Contact Tracing: If a child has been exposed to someone with active TB, close contacts should be evaluated for TB infection. Prophylactic treatment with isoniazid may be recommended for those at high risk of developing TB.

• Improved Living Conditions: Ensuring access to clean air, adequate nutrition, and sanitation can reduce the spread of TB.

Conclusion

Early diagnosis and treatment of TB in children are critical in preventing severe health complications. Parents and caregivers should be aware of the signs and symptoms of TB, especially if their child is at higher risk of exposure. With proper treatment, most children can recover from TB and lead healthy lives. 

If your child is showing any signs and symptoms of TB, do get in touch with Dr. Promilla Butani, Top Pediatrician in Delhi, for effective TB treatment for your child.