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Diagnosis of tuberculosis in children using a polymerase chain reaction

1999; Wiley; Volume: 28; Issue: 5 Linguagem: Inglês

10.1002/(sici)1099-0496(199911)28

8755-6863

David Gómez‐Pastrana, Rafael Torronteras, Pilar Caro, Maria Luisa Anguita, Antonio María López Barrio, Anselmo Andrés, Juan Carlos Navarro,

Diagnosis and treatment of tuberculosis

Pediatric PulmonologyVolume 28, Issue 5 p. 344-351 Diagnostic and Therapeutic Methods Diagnosis of tuberculosis in children using a polymerase chain reaction David Gomez-Pastrana MD, Corresponding Author David Gomez-Pastrana MD pastrana@nexo.es Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainAvenida de Sudamerica, Urbanizacion Los Cedros 7, 5°A, 11407 Jerez de la Frontera. (Cadiz), SpainSearch for more papers by this authorRafael Torronteras MD, Rafael Torronteras MD Department of Microbiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorPilar Caro MD, Pilar Caro MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorMaria Luisa Anguita MD, Maria Luisa Anguita MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorAntonio María López Barrio MD, Antonio María López Barrio MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorAnselmo Andrés MD, Anselmo Andrés MD Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorJuan Navarro MD, Juan Navarro MD Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this author David Gomez-Pastrana MD, Corresponding Author David Gomez-Pastrana MD pastrana@nexo.es Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainAvenida de Sudamerica, Urbanizacion Los Cedros 7, 5°A, 11407 Jerez de la Frontera. (Cadiz), SpainSearch for more papers by this authorRafael Torronteras MD, Rafael Torronteras MD Department of Microbiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorPilar Caro MD, Pilar Caro MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorMaria Luisa Anguita MD, Maria Luisa Anguita MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorAntonio María López Barrio MD, Antonio María López Barrio MD Department of Radiology, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorAnselmo Andrés MD, Anselmo Andrés MD Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this authorJuan Navarro MD, Juan Navarro MD Department of Pediatrics, “Virgen del Rocío” University Children's Hospital, Seville, SpainSearch for more papers by this author First published: 26 October 1999 https://doi.org/10.1002/(SICI)1099-0496(199911)28:5 3.0.CO;2-DCitations: 30AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract We investigated the value of the polymerase chain reaction (PCR) in the diagnosis of active tuberculosis in children and evaluated the relationship between PCR results in children with tuberculous infections and mediastinal adenopathies detected by computerized tomography (CT-Scan). This was a controlled, blinded, prospective study comparing nested PCR, mycobacterial cultures and the clinical diagnosis based on 350 clinical specimens from 117 children referred for evaluation of suspected pulmonary tuberculosis. All children with tuberculous infection but without active disease underwent a chest CT-scan to detect the presence of mediastinal adenopathies not evident on chest x-ray. The sensitivity of PCR was 56.8% in children with clinically active disease (culture: 37.8%; smears: 13.5%). A major advantage of PCR over cultures was noted when there was no parenchymal involvement on chest radiograph and when the patient was undergoing anti-tuberculous treatment. There were nine specimens with false-negative PCR results due to the presence of amplification reaction inhibitors. PCR was positive in five children with tuberculous infection without active disease and these children presented mediastinal adenopathies on the CT-scan that were not evident on chest radiography. There were no false-positive PCR results in the control groups of children. We conclude that nested PCR is a rapid and sensitive method for the early diagnosis of tuberculosis in children. It is especially useful when the diagnosis of active tuberculosis is difficult. In our study children with tuberculous infection without apparent disease who have positive PCR results have mediastinal adenopathies on CT-scan. Pediatr Pulmonol. 1999; 28:344–351. © 1999 Wiley-Liss, Inc. 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