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Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of the disease, the challenge in collecting appropriate specimens, and the low sensitivity of smear microscopy and culture. Culture and Xpert MTB/RIF provide higher diagnostic yield in presumptive TB in adults than in children. Current study was designed to understand poor yield of diagnostic assays in children. Children with presumptive ITTB were subjected to gastric aspirates and induced sputum twice. Samples were tested by Ziehl-Neelsen stain, Xpert MTB/RIF-assay, and MGIT-960 culture. Subjects were grouped as Confirmed, Unconfirmed, and Unlikely TB, and classified as progressive primary disease (PPD, lung parenchymal lesion), and primary pulmonary complex (PPC, hilar lymphadenopathy) on chest X-ray. Of children with culture-positive TB 51/394 (12.9%), culture-negative TB 305 (77.4%), and unlikely TB 38 (9.6%), 9 (2.3%) were smear positive, while 95 (24.1%) were Xpert-MTB/RIF positive. Xpert-MTB/RIF detected 40/51 culture confirmed cases (sensitivity 78.4% and NPV 96.3%). Culture was positive in more children presenting as PPD (p < 0.04). In culture-negative TB group, Xpert positivity was seen in 31% of those with PPD and 11.9% in those with PPC (p < 0.001). Conclusion: Xpert-MTB/RIF improved diagnosis by 2-fold and increased detection of MDR-TB. Both liquid culture and Xpert-MTB/RIF gave higher yield in children with lung parenchymal lesions. Children with hilar lymphadenopathy without active lung parenchymal lesions had poor diagnostic yield even with sensitive nucleic acid amplification tests, due to paucibacillary/localized disease, suggesting possible utility of invasively collected samples in early diagnosis and treatment.

Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of the disease, the challenge in collecting appropriate specimens, and...

September 28, 2021

BRD4 inhibition promotes TRAIL-induced apoptosis by suppressing the transcriptional activity of NF-κB in NSCLC

BRD4 inhibition promotes TRAIL-induced apoptosis by suppressing the transcriptional activity of NF-κB in NSCLC

October 5, 2021

figf, Combined photodynamic therapy with chloroaluminum phthalocyanine and doxorubicin nanoemulsions in breast cancer model

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Combined photodynamic therapy with chloroaluminum phthalocyanine and doxorubicin nanoemulsions in breast cancer model

November 16, 2021

CheXaid: deep learning assistance for physician diagnosis of tuberculosis using chest x-rays in patients with HIV

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CheXaid: deep learning assistance for physician diagnosis of tuberculosis using chest x-rays in patients with...

September 27, 2021

Seroconversion And Viral Markers

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Seroconversion And Viral Markers

December 21, 2021

Hsp70 exerts oncogenic activity in the Apc mutant Min mouse model.

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Hsp70 exerts oncogenic activity in the Apc mutant Min mouse model.

October 5, 2021

neuroscience antibodies, Nociceptor neurons promote IgE class switch in B cells

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Nociceptor neurons promote IgE class switch in B cells

November 16, 2021

Tuberculosis presenting as metastatic lung cancer

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Tuberculosis presenting as metastatic lung cancer

September 27, 2021

Maltose Phosphorylase Activity Kit

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Maltose Phosphorylase Activity Kit (Fluorometric)

December 21, 2021

triglyceride kit

Tumor Necrosis Receptor Superfamily Interact with Fusion and Fission of Mitochondria of Adipose Tissue in...

October 5, 2021

basal salt, Understanding the electrochemistry of "water-in-salt" electrolytes: basal plane highly ordered pyrolytic graphite as a model system

triglyceride kit

Understanding the electrochemistry of “water-in-salt” electrolytes: basal plane highly ordered pyrolytic graphite as a model...

November 16, 2021

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