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Amaç: Tüberküloz, neredeyse insanlık tarihi kadar eski bir hastalık olmasına ve yüz yıldan uzun bir süredir etkeni bilinmesine rağmen halen ciddi mortalite ve morbidite sebebidir. Dünya nüfusunun üçte biri bu hastalık ile enfektedir ve tüberkülozlu hasta sayısı gittikçe artmaktadır. Çocukluk çağı tüberkülozunun tanısı erişkin hastalara göre daha zordur. Çalışmamızda hastaların hangi yaş aralığında, hangi şikayetlerle başvurduğunun bilinmesi amaçlanmıştır. Ayrıca tanı koyma yöntemlerimizi ve tedavi başarımızı değerlendirmek amaçlanmıştır. Gereç-yöntem: Çalışmaya 2011 yılının Haziran Ay'ı ile 2016 yılının Haziran Ay'ı arasında Dicle Üniversitesi Çocuk Göğüs Polikliniğine başvuran, 0 – 18 yaş aralığındaki tüberküloz tanılı hastalar cinsiyet farkı gözetmeksizin alındı. Hastaların tüberküloz tanısı alıp almadığına ve tedavi başlanıp başlanmadığına epikriz, laboratuar, patoloji ve radyoloji kayıtları beraber incelenerek karar verildi. Hastalar ile ilgili yaş, cinsiyet, anne ve babalarının eğitim durumu, ailelerinin gelir durumu, evlerinde sigara içilip içilmediği, evlerinde tüberküloz tedavisi alan başka hasta olup olmadığı, kişisel risk faktörleri, eşlik eden hastalıkları, daha önce aldıkları tedaviler, hastalığın tutulum yeri, başvuru semptomları, erişkin ile temas, PPD, BCG, sedimantasyon, mide açlık sıvısında, balgamda ve bronkoalvoeolar lavaj sıvısında ARB, kültür, TBC PCR, akciğer grafisi, bilgisayarlı göğüs tomografi, patoloji sonuçları ve aldıkları tedaviler ele alındı. Bulgular: Çalışmamız 109 hasta ile yapılmıştır. Hastalarımızın yaşları 1-17 yıl arasında olup; yaş ortalaması 10,58±4,4 yıl idi. Hastaların %50,5'i (n=55) erkek %49,5 (n=54) kız idi. Hastaların %24'ü (n=26) köyde, %26'sı (n=28) ilçede %50'si (n=55) ilde yaşıyordu. Hastaların %69,7'sinin (n=76) geliri düşük (1300 liranın altında), %29,4'ünün (n=32) gelir düzeyi orta (1300 lira ile 3500 lira arasında), yalnıza %0,9'unun (n=1) gelirin yüksek (3500 liranın üzerinde) idi. Anne ve babaların eğitim düzeyi düşük idi. Evlerin %58,3'ünde sigara içiliyordu, %41,7'sinde içilmiyordu. Hastaların %23,9'unda (n=26) aile içi, %2,8'inde (n=3) aile dışı temas saptandı. Hastalar en çok %63,3 ile (n=69) öksürük, %36,7 ile (n=40) ateş şikayetiyle başvurmuşlardı. En çok tutulum yeri %78,9'u (n=86) ile akciğer tüberkülozu idi. Hastaların %60,5'inde (n=66) PPD; %44'ünde (n=48) BCG skarı pozitifti. En çok grafi bulgusu %29,4 ile hiler, mediastinal LAP, %15,6 ile parankimal infiltrasyon, %13,8 ile hiler veya mediastinal LAP'a eşlik eden parankimal infiltrasyon; en çok tomografi bulgusu ise %33,9 ile (n=37) hiler, paratrakeal ve mediastinal LAP idi. Herhangi bir yöntemle ARB bakılan 85 hasta vardı, bunlardan %12,9'unda tanesinde (n=11) en az bir yöntemle ARB saptanmıştı. Kültür çalışılan 82 hastanın %17'sinde (n=14) kültürde üreme saptandı. PCR çalışılan 36 hastanın %33,3'ünde (n=11) pozitif sonuç elde edildi. 12 hastaya biyopsi ile tanı konulmuştu. Hastaların çoğunluğu 6, 9 ve 12 ay tedavi almıştı, tedaviye uyum %90 idi, tam iyileşme %81,6 idi.Sonuç: Tüberküloz eğitim ve sosyoekonomik düzeyi düşük, kalabalık ailelerde ciddi bir halk sağlığı problemidir. Aile içi ve dışı temas çocuklar için risk faktörüdür. Tanıda altın standart olan kültürde üretme yoluyla teşhis oranı düşüktür, bu yüzden alternatif tanı yöntemlerine ihtiyaç vardır. Bilgisayarlı tomografi ve patoloji tüberküloz tanısında yararlıdır. Anahtar Kelimeler: Tüberküloz, asidorezistant basil, tüberkülin deri testi, akciğer grafisi Objective: Even though tuberculosis is an illness as old as the history of humanity and its determinant has been known for more than a century, it is still a serious cause of mortality and morbidity. One third of the world's population is infected with this illness and the number of patients with tuberculosis is increasing. The diagnosis of childhood tuberculosis is more difficult than those of adult patients. The goal of our study is to understand which patients consult for the illness in which age span and with which complaints. Besides, it is also conducted to evaluate our diagnosis methods and treatment success.Methods: The patients with tuberculosis diagnostics, who consulted to Dicle University Pediatric Chest Polyclinic between June 2011 and June 2016, and were aged between 0 and 18 years old, were included in the study regardless of their gender. The determination of whether patients received tuberculosis diagnosis and their treatment was started was decided following the co-investigation of epicrisis, laboratory, pathology, and radiology records. The following parameters were taken into account: Patients' age and gender, their mother and father's educational status, economical status of family, smoking situation at home, the presence of other members of the family who might have received tuberculosis treatment, personal risk factors, accompanying illnesses, previously received treatments, involvement location, consulting symptoms, contact with the adult, PPD, BCG, sedimentation, ARB, culture, and TBC PCR in gastric hunger fluid, phlegm and bronchoalveolar lavage fluid, chest radiography, computed chest tomography, pathology results and the treatments they received. Results: There were a total of 109 patients in our study. Our patients were aged between 1-17 years old with a mean age of 10,58±4,4 years. 55 of the patients (50,5%) were male, and 54 of them (49,5%) were female. 24% of the patients (n=26) lived in village, 26% of them (n=28) lived in town, while 50% of them (n=55) lived in city. 69.7% of the patients (n=76) had low economic status (monthly income under 1300 liras), while economic status for 29.4% of them (n=32) was medium (between 1300 and 3500 liras), and it was high (more than 3500 liras) for 0.9% of the patients (n=1). The educational status of the parents was low. Smoking occurred in 58,3% of the houses while this was not case in 41,7% of the houses. 23,9% of patients (n=26) had domestic contact, and 2,8% of them (n=3) had non-domestic contact. The patients had consulted most with the complaints of cough (63,3%, n=69) and fever (36,7%, n=40). The most common involvement location was pulmonary tuberculosis with a percentage of 78,9 (n=86). PPD was positive in 60,5% of the patients (n=66), while 44% of them (n=48) had BCG scar. The most common graphy finding was hilar mediastinal LAP (29,4%), parenchymal infiltration (15,6%), parenchymal infiltration accompanying to hilar or mediastinal LAP (13,8%); the most common tomography finding was hilar, paratrachial and mediastinal LAP (33,9%, n=37). There were 85 patients for whom ARB was examined with any method, and ARB was detected with at least one method in 11 of these patients (12,9%). Reproduction in culture was found in 17% of the patients (n=14). A positive result was obtained from 33,3% of 36 patients (n=11) on whom PCR was investigated. 12 patients had been diagnosed with biopsy. The most of the patients had 6, 9, and 12 months of treatment, compliance to therapy was 90%, and full recovery was 81,6%. Conclusion: Tuberculosis is still a serious public health problem in overcrowded families with lower educational and socio-economic backgrounds. Domestic and non-domestic contacts are risk factors for children. The rate for diagnosis through production in culture, a golden standard in diagnostics, is low, therefore there is a need for alternative diagnosis methods. Computed tomography and pathology is beneficial in the diagnosis of tuberculosis. Key Words: Tuberculosis, acidfast basil, tuberculin skin test, chest radiography 103

Aim The aim of this study was to investigate the medical and forensic importance of thorax computed tomography in stable patients with blunt chest trauma. Material and Methods Fifty patients with blunt chest injury were retrospectively evaluated with chest radiography and thorax computed tomography in the first 24 hours after trauma. Patient demographics, thoracic lesions, management options, and forensic assessment were rewieved. Results The most common lesion of the study was rib fracture. Thorax computed tomography was significantly superior to chest radiography in detecting thoracic lesions. Sixty eight (33%) occult lesions were detected. Forty six (18%) of these were life threatening that not detected with plain chest radiography. Associated injuries were present in 33 (66%) patients. Pelvic and extremity fractures were the most common injury. Thorax computed tomography was significantly superior to chest radiography in detecting pneumothorax, hemothorax and lung contusion. Eightyone life threatening lesions were detected and 50 (61%; pneumothorax 13, hemothorax 24, lung contusion 9, and pneumomediastinum 4) of these lesions could not be detected with plain chest radiography. The clinical management [in 15 patients (30%)], and the forensic assesment was changed [in 14 (28%)] patients were changed. Conclusion We concluded that using Computed Tomography of the thorax in thoracic travmas prive meticulous assesment in management of patients and forensic issues.