Adolescent Tuberculosis: 6 Years of Experience in a Tertiary Care Pediatric Hospital in Buenos Aires, Argentina

Pediatr Infect Dis J. 2023 Dec 27. doi: 10.1097/INF.0000000000004143. Online ahead of print.

Abstract

Introduction: Adolescence is a key risk period for tuberculosis disease and its adverse outcomes. This group commonly develops infectious forms of tuberculosis and has a wider range of social contacts outside the household. There are few specific data on the behavior of tuberculosis disease in this population.

Methods: A total of 292 patients aged 10-19 years with tuberculosis between January 2016 and December 2021 were retrospectively analyzed in the Department of Phthisiology of the Children's Hospital "Dr. Ricardo Gutiérrez" of Buenos Aires, Argentina.

Results: The median patient age was 14 years (interquartile range 12-16). Most patients were previously healthy, and 55% were unaware of the source of the infection. However, 75% sought medical advice owing to the presence of symptoms, with hemoptysis and weight loss being most frequent in those older than 15 years. Lung imaging findings consistent with severe disease were significantly associated with an age of >15 years. Respiratory cultures were positive in 62% of the samples obtained. Half of the patients required hospitalization, while 45% showed extrapulmonary involvement. Evolution was as follows: 74% recovered from the illness, 13% were lost to follow-up, 11% were referred to a less complex facility, 1% experienced treatment failure, and 3 (1%) patients died. Pulmonary cavities and positive bacilloscopy were associated with the presence of pulmonary sequelae at the end of treatment.

Conclusions: Tuberculosis in adolescents, particularly in those >15 years of age, may present characteristics similar to those of adults, with a higher frequency of severe pulmonary disease leading to pulmonary sequelae.