Childhood tuberculosis

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Abstract
Childhood tuberculosis will reflect the incidence of cavitating pulmonary tuberculosis in adults and will consequently be encountered most frequently in those areas with a high incidence of tuberculosis. Problem areas include our continuing inability to confirm the diagnosis of tuberculosis in many children, the escalating interaction of the human immunodeficiency virus (HIV) pandemic and tuberculosis, which is now evident with greater frequency in childhood, and the scarcity of data relating to antituberculosis therapy in childhood, which necessitates reliance on adult studies in many cases. This review highlights several options for obtaining material for culture of Mycobacterium tuberculosis in children, aspects of tuberculin testing, which remains one of the cornerstones supporting a diagnosis of tuberculosis in childhood, the potential importance of therapeutic drug monitoring in problem cases, new data giving epidemiologic and clinical details of the interaction of HIV infection and tuberculosis in children, and studies describing the epidemiology of tuberculosis in the developed and developing world.