Zusammenfassung
Während die Inzidenz der Tuberkulose in den meisten westlichen
Industrieländern rückläufig ist, gehört diese
Infektionskrankheit weltweit zu den häufigsten Todesursachen im
Kindesalter. Kinder werden meist durch Erwachsene in ihrem direkten Umfeld
infiziert. Die klinische Manifestation ist direkte Folge der
Primärinfektion und spiegelt damit die Übertragungsrate innerhalb der
Gesellschaft wider. Kinder mit unbehandelter Infektion bleiben ein lebenslanger
Pool für spätere Erkrankung und Infektionsquellen. Prävention
und Therapie der latenten Tuberkulose-Infektion sind daher grundlegende
Aufgaben des Gesundheitssystems. Kinder haben nach Infektion mit
Mycobacterium tuberculosis ein besonders hohes
Erkrankungsrisiko. Die Krankheit manifestiert sich unterschiedlich und
häufig schwerwiegender als bei Erwachsenen. Gleichzeitig ist die Diagnose
der Tuberkulose im Kindesalter aufgrund der oft unspezifischen klinischen
Präsentation sowie der Schwierigkeit des kulturellen Erregernachweises
eine besondere Herausforderung. Der Artikel gibt einen Überblick über
die Besonderheiten der Epidemiologie, Klinik, Diagnostik und Behandlung der
Tuberkulose im Kindesalter.
Abstract
In spite of a decline in the western industrialised countries,
tuberculosis remains one of the commonest causes of childhood mortality in the
world. In most cases, children become infected by adults in their immediate
environment. The clinical manifestation as a consequence of the primary
infection reflects the community transmission of tuberculosis. Children with
untreated infection remain a lifelong pool for future disease and therefore
infectivity. Thus, prevention and therapy of latent tuberculosis infection are
fundamental duties of the public health system. The risk of developing active
disease following infection with Mycobacterium
tuberculosis is especially high in children. Compared to adults, childhood
tuberculosis manifests differently and is often more severe. At the same time,
the diagnosis is complicated by the unspecific clinical presentation and
difficulty of culture confirmation in children. This article gives an overview
of the special features of the epidemiology, clinical presentation, diagnosis
and management of childhood tuberculosis.
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1 Leider wird die Durchführung eines IGRA in Deutschland bisher
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Dr. med. Klaus Magdorf
Abteilung für pädiatrische Pneumologie und Allergologie,
Helios Klinikum Emil von Behring, Standort Campus Benjamin
Franklin/Charité
Hindenburgdamm 30
12200 Berlin
Email: klaus.magdorf@charite.de
Email: anne.detjen@charite.de
