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Tuberculosis in Children
Diagnosis/Definition
- Any patient with an IPPD skin test result of greater than or equal to 10mm induration.
- Any infant, immunocompromised patient, or close contact of a patient with active TB with an IPPD reaction of greater than or equal to 5mm induration.
- Any patient, regardless of skin testing result, who has features on CXR or clinically, that are suggestive of active TB.
Initial Diagnosis and Management
- Any patient who is suspected of having TB on the basis of symptomatology or contact history should have an IPPD placed and read by a trained health care professional.
- Children in low risk groups should be routinely screened for TB exposure with an IPPD upon entrance to school, and again between ages 11-16 years.
- Children in high risk groups should be screened per the tuberculosis questionnaire, found in the Pediatric Well Child Clinic.
Ongoing Management and Objectives
- A diagnosis of possible infection with TB should be made on the basis of the strength of the skin test reaction as outlined above.
- Any positive patients should then be sent for a CXR.
Indications for Specialty Care Referral
Any patient with a positive IPPD should be referred within 4 weeks to Pediatric Infectious Disease Clinic.
Any child with evidence of active tuberculosis infection should be referred immediately to the Pediatric Infectious Disease Clinic.
Criteria for Return to Primary Care
After the patient has either been assessed to be uninfected, or has initiated therapy for treatment of a TB infection, he/she may return to primary care for management of unrelated health problems.
Infected patients should continue to have follow-up visits to the Pediatric Infectious Disease clinic for monitoring of their condition until therapy has been completed.
