Abstract:

Objective To explore the clinical characteristics and curative effect in urinary tuberculosis children, and to improve pediatricians’ awareness of this disease. Methods Clinical data of 17 urinary tuberculosis children, who were admitted to Department of Pediatric Tuberculosis, Changsha Central Hospital, University of South China from January 2015 to January 2020 and met the diagnostic criteria, were collected for descriptive statistical analysis. Results The 17 cases were from all parts of Hu’nan Province, 15 were rural cases, and 11 were boys. The median age (quartile) was 11.0 (8.5, 16.5) years. Sixteen cases had been vaccinated with BCG, and 6 cases had a clear history of exposure to pulmonary TB. Numbers of cases who complicated with pulmonary tuberculosis, tuberculous meningoencephalitis, tuberculous spinal meningitis, or abdominal tuberculosis were 14, 8, and 7, respectively. 12 cases had urinary system symptoms, including 11 cases of frequent urination, urgency, and painful urination; night sweats were found in 9 cases and 8 cases suffered fever. The abnormal urine routine were found in 12 cases, the PPD test and T-SPOT.TB were positive in 9 and 12 cases, respectively. CT scans of the urinary system showed typical manifestations of tuberculosis, urinary system involvement, and bladder wall thickening in 15, 15 and 9 cases, respectively. All children were delayed in diagnosis, and the delay time was 15 days to 9 months; they were all treated with the H-R-Z-E anti-tuberculosis as basic plan (intensive period of 3 to 6 months and consolidation period of 12 to 15 months), only 1 case who complicated with primary epilepsy changed isoniazid to pasiniazid, and used the first- and second-line anti-tuberculosis drugs (such as prothionamide, streptomycin, levofloxacin, linezolid) in combination according to the condition or effect. Finally, 6 cases were cured, 9 cases improved and continued treatment, 2 cases died. Conclusion Children with urinary tuberculosis in this province are more common in rural areas, and mainly are boys, and elder children. BCG vaccination is not protective to them. Obvious history of close contact with tuberculosis, urinary system symptoms and tuberculosis of other organs, positive in PPD test and T-SPOT.TB, CT scan with suspicious typical lesion changes are helpful to diagnosis. The curative effect is good after active treatment.

Key words: Tuberculosis, urogenital, Child, Disease attributes, Data interpretation, statistical, Diagnosis, differential, Treatment outcome