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TUBERCULOSIS IN CHILDREN

By Dr. T. VISHNU MURTHY
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Tuberculosis is an infectious disease by the tubercle bacillus. It may attack any tissue in the body and therefore manifest itself in various forms.

The exciting cause is the tubercle bacillus. The route of infection is most commonly through the respiratory system. Occasionally infection takes place through the gastrointestinal tract by injgestion of milk obtained from tuberculous cows. However , the almost universal practice of testing cow for tuberculosis, and of boiling milk for infants has reduced this mode of infection to a minimum.

The most frequent means by which tubercle bacilli are transmitted to a child is by the contact with a person having an open case of tuberculosis. This happens either kissing or by inhaling sputum droplets containing living tubercle bacilli. Unhygienic living conditions, overcrowding, malnutrition and property predispose to the disease.

Tuberculosis is believed not to be hereditary.The reason that it tends to run in families is the fact that children of tuberculous parents inherit a weakened physical constitution that makes them more susceptible to the disease. The main factor is contact, transmission of the disease being likely to occur in families, one of those whose members is already affected.

SYMPTOMS:

The symptoms vary with the location of the tuberculous process. It is customary to divide tuberculosis in children into glandular; bones and joints; pulmonary and miliary types.

Glandular Tuberculosis: The most frequent type of tuberculosis in children is that of the tracheobrochial glands also known as hilum tuberculosis. Hilum tuberculosis may produce no symptoms and may be discovered only on x-ray. On the other hand, when the tracheobronchial glands are greatly enlarged, they may produce pressure symptoms such as cough and even dyspnea. The cough may be paroxysmal in type.

Cervical adenitis is less frequently seen now than it was years ago. These glands when involved are large and tender. In rare cases they break down form one or more sinuses.

The mesenteric glands may be enlarged as part of a tuberculous peritonitis or as part of a generalised tuberculosis. They may produce abdominal pain.

Tuberculosis of the Bones and Joints:

The hip, knee, spine, and fingers are most frequently affected. Tuberculosis of the hip or knee causes pain, limitation of motion and later limping with shortening of the extremity and a shift joint. Tuberculosis of the spine, known as Pott’s disease causes spasm and pain in the muscles of the back, night cries, deformities that may result in kyphosis or scoliosis.

Involvement of the bones of the fingers ( tuberculous dactylitis ) is less common, but when it occurs, causes a characteristic deformity of the fingers.

Pulmonary Tuberculosis: Tuberculosis of the lungs is not as frequently seen in children as is glandular tuberculosis. When it occurs it is usually acute. The chronic fibrotic type met with in adults, is rare in children. The course of acute pulmonary tuberculosis resembles that of ordinary pneumonia with high temperature, cough and dyspnea. The patient doesn’t respond to chemotherapy or specific serum and the disease is often fatal.

Miliary Tuberculous: Miliary tuberculosis occurs in children who have an overwhelming throughout the body, lodging in most of the organs, such as the lungs, liver, kidneys, adrenals and meninges. The child is very toxic; has a high fever, cough and prostration. It is practically always fatal.

PROPHYLAXIS

The hope of eradicating tuberculosis in children lies in the prevention rather than in the cure of the disease. The principal sources of the infection are known, if is possible to start on the campaign for prevention of tuberculosis from two angles:

  1. The supervision of the milk supply;
  2. The prevention of contact with tuberculous persons.

Several methods are employed to prevent tuberculous infection through milk: As an additional precaution however, the milk given to a baby should be boiled for 30 min by adding equal quantity of water. The vitamin food like orange juice, grapefruit juice, tomato juice, or carrot juice added to the babies diet.

It is of primary importance to see that the child is not permitted to come into contact with any adult who suffers from open tuberculosis, even if it means separation of the adult from his family.

If one of the patients or other relatives who live in the same house with the child has a chronic cough, he should be examined by the physician.

No mother suffering from tuberculosis should be permitted to nurse her baby. It was found, however that most mothers who suffer from the disease sooner or later infect their infants through coughing or sneezing.

TREATMENT

Treatment is available for tuberculosis in children through pulse diagnosis in Ayurvedic Medicine.