Features of renal tuberculosis and other extrapulmonary tuberculosis localizations, depending on the presence or absence of the diagnosis confirmation in children

Introduction. A persistent trend towards a decrease in the incidence of extrapulmonary tuberculosis is noted both in the Omsk region and throughout the Russian Federation

Purpose of the study. To study anamnestic, epidemiological and clinical features of children diagnosed with renal tuberculosis and other extrapulmonary localizations, established by typical clinical and radiological manifestations or proven bacteriologically or histologically.

Materials and methods. A retrospective study data was carried out from 125 children aged 0-14 years in the period 2001-2018 with registered as «extrapulmonary tuberculosis» with or without lung involvement. Group 1 consisted of 50 patients with a typical clinical and radiological picture of tuberculosis, group 2 - 75 cases, with a specific extrapulmonary process, verified bacteriologically and/or using molecular genetic methods or histology. The differences between groups were determined using Pearson's χ2 test.

Results. The predominance in the structure of confirmed and established extrapulmonary process of renal tuberculosis was established, and children living in urban areas had better accessibility of diagnostic methods for verifying extrapulmonary tuberculosis (62.7%, p < 0.05). A history of concomitant pathology (94.7%, p < 0.05) and the availability of the lesion for bacteriological or histological examination (urine, pus, punctate) increased the likelihood of diagnosis verification. Most of the considered factors for renal tuberculosis in children did not differ significantly. Hyperergic results (up to 24%, p < 0.05) of immunological tests, the presence of complaints of dysuric disorders (21%, p < 0.05) prevailing in groups of children with an established diagnosis of tuberculosis kidneys, only suggest the presence of MBT-infection and do not prove the specific nature of the disease, while systematic preventive work on the examination of the risk group allows timely diagnosis of the disease at an early stage of the disease (up to 26%, p < 0.05).

Conclusion. The widespread improvement of material and technical equipment, the introduction of new diagnostic techniques (PCR of urine) into routine practice, training of medical personnel in assessing prevalence issues and early detection of the disease can improve the quality of verification of this nosology.

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