[Surgical aspects of primary tuberculosis in children: clinical presentation and indications for surgical treatment].

AIM: During the last years a trend of increasing the cases with primary pulmonary tuberculosis (PPT) in our country is observed. The aim of this study is to analyze retrospectively the pediatric cases with PPT and to determinate the specific clinical features as well the indications for surgery.

MATERIAL AND

METHODS

For a period of six years (2000-2005) thirteen children with PPT were treated at the Department of pediatric surgery. The patients underwent different type surgical procedures. Lobectomy was the most frequent operation.

RESULTS

The initial diagnosis at admission was: chronic pneumonia, mediastinal tumor, complicated hydatid cyst, congenital lung cyst and pleural complication of PPT. The radiological features were typical for PPT in only two cases. The remaining showed atypical presentation and the diagnosis were confirmed by histopathological study of the surgery specimens. There were no postoperative complications and no late morbidity.

DISCUSSION AND

CONCLUSION

We classify the clinical course of children with PPT into three groups: 1) Identified PPT - two children, 2) Suspected PPT according the criteria of Migliori - six children and 3) Non identified PPT - five children. The diagnosis of the childhood pulmonary tuberculosis presents a major challenge. The most common radiological features are similar to those of other pulmonary affections and a thorough examination of symptoms of disease is necessary. Surgery has a complementary role in the complex treatment in children with PPT.