Paediatric Pulmonology and Allergology

2004 October, Vol. VII, No. 2 (2589-2594)

Case of smear positive pulmonary tuberculosis in a secondary school

Elena Sučiliene, Danute Budgeniene, Laima Daukiene, Arnoldas Kuzmickis, Arunas Valiulis

Tu­ber­cu­lo­sis (TB) is air­bor­ne tran­smit­ted in­fec­tio­us di­se­a­se. Risk to be in­fec­ted de­pends on the con­cen­tra­tion of My­co­bac­te­rium tu­ber­cu­lo­sis (MT) in the air, ti­me of ex­po­si­tion,vi­ru­len­cy of MT, the im­mu­ne sta­tus of the per­son. Child­ho­od TB of­ten isn’t tran­smis­sib­le, but te­ena­gers can be sick with con­ta­gio­us adult TB forms. Sme­ar po­si­ti­ve pul­mo­na­ry tu­ber­cu­lo­sis has be­en de­tec­ted for 17 year old stu­dent of a se­con­da­ry scho­ol. The aim of the stu­dy was to eva­lu­a­te the ex­tent of tran­smis­sion of tu­ber­cu­lo­sis in this ca­se. 323 con­tacts of in­dex TB ca­se we­re in­ves­ti­ga­ted by Man­toux test with 2 TU of tu­ber­cu­lin PPD-RT 23, po­si­ti­ve re­ac­tors we­re chest X-raid. 72.7 perc. of clas­sma­tes of in­dex TB ca­se and 18.4 perc. of stu­dents of the sa­me gra­de had la­tent TB in­fec­tion. The po­si­ti­ve re­ac­tion to tu­ber­cu­lin among stu­dents of ot­her gra­des was re­ve­a­led in 24.7 perc., 15.7 perc. and 12.3 perc. Non of con­tact stu­dent in ti­me of in­ves­ti­ga­tion was sick with TB. La­tent TB in­fec­tion was hig­her among clas­sma­tes of in­dex TB ca­se than among the sa­me or ot­her gra­de stu­dents (p<0,0001). Lar­ge ra­te of TB in­fec­tion al­lows to con­si­der My­co­bac­te­rium tu­ber­cu­lo­sis to be of a high vi­ru­len­ce in this ca­se.

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