Chronic Pulmonary Tuberculosis in Individuals with Known Previous Primary Tuberculosis

¹ The Chest Clinic, Children's Medical Service, Bellevue Hospital, New York City and the Department of Pediatrics, New York University College of Medicine.

A group of 113 patients with chronic pulmonary tuberculosis has been presented, all of whom had their primary infection during childhood.

Although admissions to the children's tuberculosis ward were about equally divided between boys and girls, only one-half as many males as females later developed chronic pulmonary tuberculosis.

During follow-up of 622 consecutively seen children with uncalcified primary tuberculosis 35 (7.6 per cent) of the survivors developed chronic pulmonary tuberculosis after intervals of three months to over 20 years.

The risk of chronic pulmonary tuberculosis was greater in children in whom primary tuberculosis developed at the age of seven years or more.

The risk of developing chronic pulmonary tuberculosis was apparently greatest in adolescence irrespective of the age when the primary was diagnosed.

Forty per cent of the cases of chronic pulmonary tuberculosis developed within two years of the menarche.

The majority of instances of chronic pulmonary tuberculosis were found through routine roentgenogram; in 75 per cent the disease was minimal.

Only one-third of the patients had symptoms attributable to the pulmonary lesion at the time of diagnosis of chronic pulmonary tuberculosis.

This series of cases emphasizes the importance of keeping children with primary tuberculosis under long term observation in order to make the earliest possible diagnosis of chronic pulmonary tuberculosis and to gain information about the pattern of its development.

None of the children reported here received specific therapy during the primary phase of the disease. Follow-up of a similar series of children who have been treated by antimicrobial therapy for primary tuberculosis might be instructive.