Study of clinical profile of childhood extra pulmonary tuberculosis

Dhara K. Gosai, Jigar B. Gosai, Omprakash S. Shukla


Background: Tuberculosis is the second most common cause of death from infectious disease at the global level, being second only to AIDS. Good data on the burden of all forms of TB amongst children in India is not available; most surveys conducted have focused on pulmonary TB. The present study was designed to study clinical profile of various forms of childhood EPTB. Objective of current study was to study clinico-epidemiological profile of various forms of childhood EPTB.

Methods: Retrospective analysis of clinical profile of 100 patients of childhood EPTB in the age group of 6 months to 12 years.

Results: Age distribution in our study showed that 62% cases falling in the age 0-5 years and 38% cases in 5-12 years (P = 0.041) with male to female ratio of 1.9:1. 96% (P = 0.016) of the patients belonged to the lower socio-economic class (P = 0.01). The distribution of EPTB was - TBME (46%), disseminated TB (21%), pleural effusion (12%), abdominal TB (10%), TB lymphadenitis (7%), Osteoarticular (4%). 28% of the patients had mild to moderate malnutrition (PEM Grade-I,II)  and 46% (PEM Grade-III,IV) were severely malnourished. 66% of the patient were BCG vaccinated & history of  Koch’s contact were present in 28% of the all cases. In CNS tuberculosis, fever was present in 97% followed by altered sensorium & convulsion in 80%, tonic posturing in 60% & abnormal movements in 4% and in most common sign was tonic posturing in 60%, crack pot sign positive in 41%. In abdominal tuberculosis - fever (100%), anorexia (90%), weight loss (80%) abdominal pain (50%) & hepatomegaly was common finding seen in 100% of abdominal tuberculosis.

Conclusion: Childhood EPTB is commonly seen in children age more than 1 year, lower socioeconomic class & in severely malnourished. CNS tuberculosis commonly present with fever, altered sensorium, convulsion, abnormal movements while abdominal TB present with fever, anorexia, weight loss & abdominal pain.


Clinical profile, Childhood, Extra pulmonary tuberculosis

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K Park. Health Programs in India. In: K Park, eds. Park’s Textbook of Preventive and Social Medicine, 20th ed. Jabalpur: Banarsidas Bhanod publication; 2009: 305-319.

Balachandra A., Shiv bolan S., Govrishankar M. C., Childhood TB Current Scenario. Indian J of Pract Pediatr. 2007;3:6-9.

Ministry of Health & Family Welfare & Experts of IAP. Management of pediatrics tuberculosis under RNTCP - Joint statement of central TB division, Directorate general of health services, 2003. Available at:

Ministry of Health & Family Welfare. TBC India directorate general of health service, 2010. Available at: Accessed March 2010.

The Government of India. Case finding policy for National TB control programme. Indian J Tub. 1998;45:3-7.

Van Well et al. Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western cape of South Africa. Netherlands, Neoreviews official J American Acad Pediatr. 2009;123:e1-8.

Cherry Lyn. P. Clinical profile of culture proven Tuberculosis cases among Filipino Children aged 30 months to 18 years. Phil J Microb Infect Dis. 2001;30(4):133-43.

Rehman Anis-or, Idris Mahammad. Comparison of Mantoux test with diagnostic BCG in pediatric patients with pulmonary tuberculosis. J Ayub Med Coll Abottabad. 2005;17:6-8.

Garg P. Childhood tuberculosis in a community hospital from a region of high environmental exposure in North India. J clin diagnost Res. 2003;2(4):634-8.

Fawzia Al Otaibi Malak et al. King Khalid University Hospital: Study on extra pulmonary TB in Saudi Arabia. Saudi Arabia. 2010:227-31.

Tahmeed Ahmed, Farzara Sobhan. Childhood Tuberculosis a review of epidemiology. Diagnosis & Management. Infect Dis J Pakistan. 2008;17:52-60.

Thilothammal, P. V., Krishna Murthy, Basu K., Ratnam S. R. Tuberculosis meningitis in children, clinical profile mortality & morbidity of bacteriologically confirmed cases. Indian Pediatr. 1995;32:641-6.

Van Rie A, Byers N, Gie R, Kunneke M., Zeitsman L, Donald P. Childhood tuberculosis in an urban population in South Africa: Burden & NSK factor : Arch Dis Child. 1999;80:433-7.

Nooshin Baghaie, Soheila Khalilzade. extra pulmonary tuberculosis in children: two years study. Pediatric respiratory research centre, Tehran, Iran. Acta Medica Iranica. 2010;48(4):239-43.

Sheth V., Kabra S. K., Jain Y., Semwal O. P. Study on EPTB. Inst Med Sci. 1994;31:1585-93.

Schaaf H, Marais B. J., Whitelow Andrew, Anneke C. Hesseling, Eleg Brian, Husseg G. D., Donald P. R. Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC Infect Dis. 2007;7:140.

Matloob Azam et al. Intracranial tuberculoma & caries spine: study in children’s hospital Islamabad. J Ayub Med College, Abbottabad, Islamabad. 2004;16(4):7-11.

Nelson L J, Wells Co. Global epidemiology of Childhood tuberculosis. Inst. J Tub Lung Dis. 2004;8(5):636-47

Agrawal R. K. To be or not to be and TB or not TB? Indian Pediatr. 2008;45:259-60.

Sheth V., Kabra S. K., Jain Y., Semwal O. P. Study on EPTB. Inst Med Sci. 1994;31:1585-93.

Yadav MS et al. A comparative study of DOTS & Non - DOTS interventions in tuberculosis cure, Kasturba medical college, Mangalore. Indian J Community Med. 2004;29:1.