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How to manage children who have come into contact with patients affected by tuberculosis.

Authors
  • Lancella, Laura1
  • Vecchio, Andrea Lo2
  • Chiappini, Elena3
  • Tadolini, Marina4
  • Cirillo, Daniela5
  • Tortoli, Enrico5
  • de Martino, Maurizio3
  • Guarino, Alfredo2
  • Principi, Nicola6
  • Villani, Alberto1
  • Esposito, Susanna6
  • Galli, Luisa3
  • 1 Unit of General Pediatrics and Pediatric Infectious Diseases, IRCCS Bambino Gesù Hospital, Rome, Italy. , (Italy)
  • 2 Section of Pediatrics, Department of Translational Medical Science, Federico II University of Naples, Naples, Italy. , (Italy)
  • 3 Pediatric Clinic, Meyer Hospital, University of Florence, Florence, Italy. , (Italy)
  • 4 Section of Infectious Diseases, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. , (Italy)
  • 5 Microbiology Unit, IRCCS San Raffaele Hospital, Milan, Italy. , (Italy)
  • 6 Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. , (Italy)
Type
Published Article
Journal
Journal of clinical tuberculosis and other mycobacterial diseases
Publication Date
Nov 01, 2015
Volume
1
Pages
1–12
Identifiers
DOI: 10.1016/j.jctube.2015.07.002
PMID: 31723675
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Childhood tuberculosis (TB) indicates a recent infection, particularly in children aged < 5 years, and therefore is considered a sentinel event insofar as it highlights the presence of an undiagnosed or untreated source case. The risk of acquiring TB is directly proportional to the number of bacilli to which a subject is exposed and the environment in which the contact occurred. This document contains the recommendations of a group of Italian scientific societies for managing a child exposed to a case of TB based on an analysis of the risk factors for acquiring latent tuberculous infection (LTBI) and developing the disease, and the particular aspects TB transmission during the first years of life. The guidance includes a detailed description of the methods used to identify the index case, the tests that the exposed child should receive and the possibilities of preventive chemoprophylaxis depending on the patient's age and immune status, the chemotherapy and monitoring methods indicated in the case of LTBI, the management of a child who has come into contact with a case of multidrug-resistant or extensively drug-resistant TB, and the use of molecular typing in the analysis of epidemics. The group of experts identified risk factors for tuberculous infection and disease in pediatric age as well as gave recommendation on management of contacts of cases of TB according to their age, risk factors and exposure to multidrug-resistant or extensively drug-resistant TB. © 2015 The Authors.

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