Pediatric tuberculosis : Clinical presentation and contact investigation at an urban medical center

(A) To characterize the clinical presentation of pediatric tuberculosis in Los Angeles County; (B) to determine the efficacy of contact investigation in identifying a source case for children with tuberculosis. We reviewed the medical records, chest radiograph and Tuberculosis Control records of 34 children (age < 15 years) evaluated at Los Angeles County from January 1992 through December 1993. All patients were Hispanic. The mean age was 2.2 years. Thirty-three patients (97%) had intrathoracic disease. Eighteen patients (53%) were symptomatic and the most common symptoms were fever and cough. The contact investigation revealed only 4 patients (2%) to be adult source cases with active tuberculosis. The clinical features of pediatric tuberculosis in Los Angeles County confirm results previously reported in other parts of the US. In contrast, the identification of adult source cases is suboptimal. Improved methods of contact tracing are needed when evaluating children with tuberculosis.