OBJECTIVE : Tuberculosis (TB) in children remains a major concern, because the diagnosis is complex and difficult. This study aims to describe the diagnostic patterns of pulmonary, extrapulmonary and mixed (pulmonary and extrapulmonary) TB based on clinical presentation, bacteriology (sputum acid fast staining) and chest x-ray in Dr. Kariadi Hospital, Semarang.
METHOD : We reviewed medical records of children aged 0-18 years with TB from January 2017 to April 2019. Clinical features, Tuberculine Skin Test (TST), acid – fast staining of sputum, and chest x ray were studied. Data analysis was performed using descriptive statistics.
RESULT : We found 153 children with 66,7% pulmonary, 9,8% extrapulmonary, and 23,5% mixed TB. Pulmonary TB with positive TST was 28.4 %, positive bacteriology was 14.7 %, chest x-ray suggested TB was 86.3 %. Extrapulmonary TB with positive TST was 60 %, positive bacteriology was 13.3 %, chest x-ray TB was 0 %. Mixed TB with positive TST was 22.2 %, positive bacteriology was 25 %, chest x-ray suggested TB was 100 %. The most common symptoms in pulmonary, extrapulmonary and mixed TB were prolonged fever (80,4%, 80%, 72%), cough (74,5%, 13,3% and 44,4%), and malnutrition (82%, 46% and 83%).
CONCLUSION : Prolonged fever is the most frequent symptom in pulmonary, extrapulmonary, and mixed TB. Mixed TB has higher positive results in positive acid-fast bacteriae and chest x-ray suggestive of TB, but positive TST was less than pulmonary and extrapulmonary TB. It might be due to malnourish condition. Timely and prompt diagnostic and treatment should be encouraged in mixed TB.