1. Childhood Tuberculosis 檀卫平 中山二院 Tan-weiping

8. Dr. Robert Koch discovered the tuberculosis bacilli in 1882 He received the Nobel Prize in physiology or medicine in 1905 for this discovery

20. A characteristic tubercle at low magnification ( A ) and in detail ( B ) central caseation surrounded by epithelioid and multinucleated giant cells(C) mycobacteria with acid-fast stains ( D ).

37. Table 39-1 -- The Stages of Tuberculosis in Children The Stages of Tuberculosis in Children Three or four One One Number of drugs Always Always If <5 years old Treatment Usually abnormal Usually normal Normal Chest radiograph Usually abnormal Normal Normal Physical examination Positive (90%) Positive Negative Skin test Disease Infection Exposure STAGE

55. Tuberculous meningitis

65. Miliary tuberculosis in an infant whose uncle also had tuberculosis. There is adenopathy in addition to the millet seed–like lesions

67. A posteroanterior (A) and lateral (B) chest radiograph of a child with hilar adenopathy caused by Mycobacterium tuberculosis.

68. Hilar and mediastinal adenopathy and a partial segmental lesion in a child with tuberculosis

69. Lobar pneumonia with bowing of the horizontal fissure in a child with tuberculosis. a secondary bacterial pneumonia may have been present

70. Tuberculous pleural effusion in a teenage girl. The pleural biopsy had caseating granulomas

72. A magnetic resonance image of tuberculoma in a child with culture-positive tuberculous meningitis. The child's presenting signs and symptoms included fever, altered mental status, and hemiparesis

73. Thank you