DIAGNOSTIC PATTERNS OF TUBERCULOSIS IN CHILDREN

IN DR. KARIADI HOSPITAL SEMARANG

Agung Hari Wibowo​, Moh Syarofil Anam, Dwi Wastoro Dadiyanto,Riza Sahyuni,
Magdalena Sidhartani
Department of Pediatrics, Faculty of Medicine, Diponegoro University,
Dr. Kariadi Hospital, Semarang, Indonesia

OBJECTIVE : Tuberculosis (TB) in children remains a major concern, because

the diagnosis is complex and difficult. This study aims to ​describe the diagnostic
patterns of pulmonary, extrapulmonary and mixed (pulmonary and
extrapulmonary) TB based on clinical presentation, bacteriology (sputum acid fast
staining) and chest x-ray in Dr. Kariadi Hospital, Semarang.
METHOD : We reviewed medical records of children aged 0-18 years with TB
from January 2017 to April 2019. ​Clinical features, Tuberculine Skin Test (TST),
acid – fast staining of sputum, and chest x ray ​were studied​. Data analysis was
performed using descriptive statistics.
RESULT : ​We found ​153 children with 66,7% pulmonary, 9,8% extrapulmonary,
and 23,5% mixed TB. Pulmonary TB with positive TST was 28.4 %, positive
bacteriology was 14.7 %, chest x-ray suggested TB was 86.3 %. Extrapulmonary
TB with positive TST was 60 %, positive bacteriology was 13.3 %, chest x-ray TB
was 0 %. Mixed TB with positive TST was 22.2 %, positive bacteriology was 25
%, chest x-ray suggested TB was 100 %. The most common symptoms in
pulmonary, extrapulmonary and mixed TB were prolonged fever (80,4%, 80%,
72%), cough (74,5%, 13,3% and 44,4%), and malnutrition (82%, 46% and 83%).
CONCLUSION : Prolonged fever is the most frequent symptom in pulmonary,
extrapulmonary, and mixed TB. Mixed TB has higher positive results in positive
acid-fast bacteriae and chest x-ray suggestive of TB, but positive TST was less
than pulmonary and extrapulmonary TB. It might be due to malnourish condition.
Timely and prompt diagnostic and treatment should be encouraged in mixed TB.

KEYWORDS:​ Tuberculosis, Children, Chest x-ray, Pulmonary, Extrapulmonary