Medical insider
Dr ria maslog
July 30, 2023
Progressive Primary Tuberculosis
Last issue, we discussed the Primary infection of tubercle
bacilli. Let us now talk about the clinical form of
tuberculosis that is responsible for the numerous
mortalities in children. This is called the progressive
primary tuberculosis.
Children with: energy/protein undernutrition, with anemia,
with intestinal parasitism and repeated intercurrent
infections are the most vulnerable population.
Clinically, the affected children will have intensification of
the symptomatology of the primary infection. They will
appear visibly ill because the fever may be present daily
and may become high grade with the cough becoming
more distressing.
So, it is very important to have a very high index of
suspicion and you must bring the child to a specialist for
physical examination and laboratory testing so that proper
assessment and management can be instituted.
During physical examination, the physician can see that
the child has difficulty in breathing because of the greater
area of the lung that is affected and involved. Hemoptysis
can be present only in cases of cavitary diseases.
With proper antimicrobial therapy, mortality rate has been
reduced except in young children with malnutrition below 5
years of age. Some children may ultimately develop
bronchiectasis and cor pulmonale.