Suspicion of child’s tuberculosis should be suspected of tuberculosis in the following cases (F. Miller, 1984):
10.Any abscess localized in a peripheral lymph node,especially developed gradually.
11.Subcutaneous abscesses or ulcers on the skin with no having no apparent cause.
12.A sudden and unexplained change of the child's mood, accompanied by rise in body temperature, sometimes nausea and headaches.
13.Weight loss and apathy in older children older children and adolescents in conjunction with
productive cough.
Suspicion of child’s tuberculosis should be suspected of tuberculosis in the following cases
(F. Miller, 1984):
14.Prolonged convalescence after having had measles, whooping cough, streptococcal tonsillitis or other intercurrent infection.
15.Signs of a volumetric intracranial process or diffuse encephalitis in children.
16.Painless hematuria or sterilepyuria in a child.
NEWLY DIAGNOSED PATIENTSIN ACCEPTANCE
PATIENTS TO BE EXAMINED ARE:
1.With symptoms of inflammatory bronchopulmonary disease:
•a prolonged cough (more than 2-3 weeks) with sputum sputum secretion;
•hemoptysis and pulmonary hemorrhage;
•chest pain related to breathing;
2.With persistence for more than 2-3 weeks intoxication symptoms:
•Increased body temperature;
•weakness;
•increased sweating, especially at night;
•loss of body weight.
All persons with symptoms of the respiratory organs are given a mandatory diagnostic minimum:
1.Clinical examination: examine complaints, history, physical examination.
2.Laboratory examination: sputum is examined three times under microscopic examination: sputum (if available) for Acid-resistant mycobacteria, using Ziehl-Nelson staining.
3.Radiological examination of the thoracic organs thoracic radiographs in an institutionally accessible volume(optimum: use of digitalfluorography).
4.Tuberculin-diagnosis: Mantoux test, Dyskintest.
PRINCIPLES OBSERVATION
TYPICAL COMPLAINTS:
1.WEAKNESS.
2.INCREASED FATIGUE.
3.WORSENING OF APPETITE.
4.LOSING WEIGHT.
5.IRRITABILITY.
6.LACK OF CAPACITY FOR WORK.
7.INCREASED BODY TEMPERATURE (FEVER).
8.INCREASED SWEATING (INCLUDING NIGHT SWEATS).
9.COUGHING.
10.PRESENCE OF SPUTUM. 11.PAIN IN THE CHEST.
12.HEMOPTYSIS (PULMONARY HEMORRHAGE).
LABORATORY METHODS RESEARCH
1.TOTAL BLOOD COUNT.
2.GENERAL ANALYSIS OF URINE.
3.BIOCHEMICAL BLOOD TEST.
4.BLOOD COAGULATION SYSTEM TEST.BONE ANALYSIS.
5.HORMONAL STUDIES.
6.MICROBIOLOGICAL STUDIES.
7.IMMUNOLOGICAL STUDIES.
SEROLOGICAL STUDIES: ANTIGEN DETECTION,
ANTIBODY DETECTION (AFA)
ANDTUBERCULIN PROVOCATION TESTS.
8. MOLECULAR BIOLOGY EXAMINATIONS (PCR).
METHODS OF TUBERCULOSIS
DIAGNOSIS DETECTION OF THE TUBERCULOSIS PATHOGEN:
• Indirect Methods:
-Tuberculin-diagnosis (Mantoux,)Diakintest);
-Determination of anti-tuberculosis antibodies;
-Investigation of the release of γ-interferon under the influence of MBT specific agents.
• Direct methods:
-bacterioscopic diagnosis; -bacteriological diagnosis; -MBT antigen detection; -molecular biological methods.
3.TUBERCULINODIAGNOSTICS - a set of diagnostic tests to determine specific sensitization of the body to MBT using tuberculin. autoclaved infiltrate of MBT cultures.
•TUBERCULIN is an incomplete antigen (hapten) that is not capable of causing disease or the development of immunity to it, but induces a specific reaction, referred to as an allergy delayed type allergy, is highly specificity. The occurrence of a specific reaction is only possible under the condition of prior sensitization of the organism MBT as a result of spontaneous infection or BCG vaccination.
DIASKINTEST -
•tuberculosis allergen recombinant in standard dilution of 0.2 µg in 0.1 ml, solution for intradermal injection,intradermal solution, which is a recombinant protein produced by a genetically modified culture Escherichia coli BL21 (DE3)/pCFP- ESAT,diluted in sterileisotonic phosphate buffersolution, with a preservative (phenol).
•The preparation contains two antigens,present in the virulent strains MDR-TB virulent strains that are absent from the BCG vaccine strain
DIASKINTEST -
•The test allows us to clearly differentiate between immune reactions due to M. tuberculosis infection because the drug does not cause hypersensitivity delayed-type hypersensitivity associated with vaccination BCG.
•Introduction of a new diagnostic method of tuberculosis infection that has high specificity through Use of the secretory proteins ESAT-6 andCFP-10 and is as easy to perform as the The Mantoux test will dramatically increasethe level of detection of tuberculosis.
•The drug is registered in the Russian Federation.The registration certificate LD-006435/08 of 11.08.2008.