Recently, much progress has been achieved in the treatment of tuberculosis, but it is far from effective supression or control. children, especially from underprivileged families are still in grest danger of being infected from parents or other family members with open tuberculosis. We have reviewed 50 pediatric patients who were radiologically confirmed to have miliary tuberculosis during the 3 years since June 1967.
The following results were obtained :
1. Forty percent of these patients were between 1 to 3 years of age.
2. The majority of cases were seen during the warm seasons.
3. Fifty four percent of patients had a definite history of contact with tuberculous patients. Most frequent contact age group were 1~3 years of age, and a parent was the contact in 67%.
4. The chief complaint at admission were in the order of frequency : fever, cough, and general weakness. Patients with vomiting, convulsion and personality change had tuberculous meningitis.
5. General weakness and severe nutritional deficiency were usually evident on physical examination.
6. Among these miliary tuberculosis patients, 40% were AFB positive, 20% from gastric washing, 14% from sputum, and 6% from other sources.
7. Since measles proceded tuberculosis in 20% of all cases, close observation during the postmeasles period is stressed.
8. Befere hospitalization, 36% of patients received ineffective treatment by their parents, 24% of patients received no treatment at all and 40% had relatively effective treatment.
9. In one case, the tiny primary complex developed to a full-blown miliary tuberculosis in less than a month.
10. Forty eight percent of miliary tuberculous patients progressed to tuberculous meningitis which was often fatal, being the commonest cause of deaths.
11. Corticosterids were added in 24 cases of tuberculous meningitis, resulting in remission in 15 cases. Nine severe cases ended fatally in spite of steroid regimen.
12. Statistical studies on the resistant rate to primary drugs in pediatric tuberculosis in Korean children are necessary.
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