Children

® Because very young children (less than 5 years old) have immature cellular immunity, TB can be particularly dangerous in this population. TB in children may present as a typical bacterial pneumonia, called progressive primary TB, and often involves the lower and middle lobes.17,19-21 Dissemination to the lymph nodes, GI and genitourinary tracts, bone marrow, and meninges is fairly common. For these reasons, bacille Calmette-Guerin (BCG) vaccinations are administered in countries where

TB remains common. BCG appears to stimulate the children's immune systems just enough to ward off the most serious forms of the disease. However, BCG does not block infection, and these same children often experience reactivation TB as young adults. Because cavitary lung lesions are uncommon, children do not spread TB readily. From the public health perspective, pediatric TB is the clearest indication of recent spread of TB.

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