Characteristics of pediatric TBl.More severe tuberculosis infection2. Tissues and organs are hypersensitivity totuberculosis bacili Intrapulmonary : there is an extensive inflammationaround primary focus Extrapulmonary : erythema nodosum, phlyctenulalconjunctivitis andmultiple transient arthritis3. Lymphatic system involved widely
Characteristics of pediatric TB 1. More severe tuberculosis infection 2. Tissues and organs are hypersensitivity to tuberculosis bacili □ Intrapulmonary：there is a n extensive inflammation a rou n d primary focu s □ Extrapulmonary：erythema n od osu m, phlyctenular conjunctivitis a n d multiple transient arthritis 3. Lymphatic system involved widely
4.Systemic spread tendencyoccult hematogenic spreadacute generalized hematogenic spread
4. Systemic spread tendency o c c u l t hematogenic sp r ead a c u t e generalized hematogenic spread
4. Systemic spread tendencyOccult hematogenic spread most common sporadic, small number no immediate clinical manifestation remote foci in almost every organ,especially inorgans of rich vascularization such as brain,liver, bones&joints, kidney, lung-apexregion under normal cell mediated immunity, they aresilent foci (dormant)- potential for reactivation
4. Systemic spread tendency O c cu l t hematogenic sp r ead □ most common □ sporadic, small n u mb er □ n o immediate clinical manifestation □ remote foci in almost every organ,especially in orga n s of rich vascularization su ch a s brain, liver, bones&joints, kidney, lung-apex region □ u n d er normal cell mediated immunity, they are silent foci (dormant) □ potential for reactivation
Acute generalized hematogenic spreadlesscommon large number immediate clinical manifestation:disseminated TBmilliary TBtuberculous meningitistubercle in same size, special appearanceinCXR
A c u t e generalized hematogenic spread □ less common □ large n u mb er □ immediate clinical manifestation:disseminated TB □ milliary TB □ tuberculous meningitis □ tubercle in s a me size, special a p p ea ra nce in CXR
5.the location of primary focus in lungs is special6. prognosis is good in most children with primarytuberculosis and lesion is healed withabsorption, calcification or scleroma7. Most of them have contact history withtuberculosis patients8. The younger the patient, the more valuable ofPPD test
5. the location of primary focus in lungs is special 6. p r ognosis is good in most children with primary tuberculosis and lesion is healed with absorption, calcification or scleroma 7. Most of them have contact history with tuberculosis patients 8. The younger the patient, the more valuable of PPD test