Yonsei Med J.
1969 Dec;10(2):146-152. 10.3349/ymj.1969.10.2.146.
Clinical Review of Miliary Tuberculosis in Korean Children: 84 Cases and Review of the Literature
- Affiliations
-
- 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- KMID: 1107455
- DOI: http://doi.org/10.3349/ymj.1969.10.2.146
Abstract
- Tuberculosis is still one of the most serious infectious diseases in Korea. Tuberculosis in childhood is a serious prablem to Korean pediatricians. Miliary tuberculosis, a form of extrapulmonary tubercubsis, has been frequently observed in outpatient dispensaries or in-patient wards in Korea. Only one clinical review by Mm et al (1969) was reported. We have summarized another eighty four psdiatric patients who were observed during a nine years and three months period from Jan. 1960 to March of 1969, at Wonju Union Christian Hospital, Wonju, Kang Won Do, a branch hospital of our Saverance. The following results were obtained; 1). During nine years and three months from Jan. 1960 to March of 1969, eighty four cases of miliary tuberculosis were observed which was 1.7 per cent of the total admission of pediatric patients (4,991) during the above period. 2). The youngest one was a five month old female infant and the oldest was a thirteen year old boy. The age group of three to six years included 40.5 per cent while 10.7 per cent were under one year. 3). Only eighteen per cent of the patients had a definite contact history with tuberculosis in the family. 4). Their chief complaints on admission were fever, cough, vomiting, loss of appetite, abdominal pain, fatigue, in order. All eight convulsive patients had complication of meningitis. 5). Negative tuberculin responses were found in more than fifty per cent of patients. 6). Tuberculous meningitis was the most frequent complication (28.5 per cent)in miliary tuberculosis. Tuberculous complications were found in fifty per cent of all patients. 7). Death rate was twelve per cent. Six out of ten deaths occurred within three days after admission. Eight out of ten deaths were complicated cases of tuberculous meningitis. Seven out of ten deaths were male patients. 8). In improved cases, improvement on X-ray and by clinical symptoms appeared after two weeks or several months. 9). The Patients were treated by triple chemotherapy and addition of corticosteroid, but we did not find a remarkable effect of steroid. 10). The prevention must precede treatment and doctor's and patient's attention to miliary tuberculosis must be emphasized.
