<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312021000300013</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tuberculosis osteoarticular en un paciente pediátrico]]></article-title>
<article-title xml:lang="en"><![CDATA[Osteoarticular tuberculosis in a pediatric patient]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Toledo Martínez]]></surname>
<given-names><![CDATA[Juan Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Umaña Portillo]]></surname>
<given-names><![CDATA[Andrea Nicole]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paz]]></surname>
<given-names><![CDATA[José María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad católica de Honduras Facultad de Medicina y Cirugía ]]></institution>
<addr-line><![CDATA[ San Pedro Sula]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Asociación Científica de Estudiantes de Medicina Universidad Católica de Honduras Campus San Pedro y San Pablo (ASOCEM UNICAH SPSP)]]></institution>
<addr-line><![CDATA[ San Pedro Sula]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Hondureño de Seguridad Social-Hospital Regional del Norte  ]]></institution>
<addr-line><![CDATA[ San Pedro Sula]]></addr-line>
<country>Honduras</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>93</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312021000300013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312021000300013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312021000300013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La tuberculosis osteoarticular es una enfermedad inflamatoria crónica, muy rara con un cuadro clínico atípico y se presenta con una incidencia de 1-2 % del total de los casos de tuberculosis.  Objetivo:  Exponer una forma de presentación poco frecuente de tuberculosis en Honduras  Presentación del caso:  Se trata de una niña de dos años con diagnóstico inicial de sinovitis en rodilla derecha de cinco meses de evolución y tratada con antibiótico y analgésico. Sin mejoría se presenta a emergencia con cambios inflamatorios. Se realiza rayos x de rodilla que muestran lesiones osteolíticas a nivel de rótula y cóndilo del fémur derecho. Baciloscopia de esputo y prueba de tuberculina negativas. Familiar de tercer grado positivo para tuberculosis hacía un año y medio. Por biopsia de tejido blando y óseo de rodilla derecha se establece el diagnóstico de artritis por Mycobacterium tuberculosis por estudio inmuno-histoquimico con tinción Ziehl Nielsen.  Conclusiones: Es el primer informe de caso de tuberculosis osteoarticular en un paciente pediátrico descrito en Honduras. Por la larga evolución de la enfermedad, lo atípico de su clínica y su baja incidencia es difícil establecer el diagnóstico final. Fue imprescindible el estudio anatomopatológico por biopsia que permitiera esclarecer a los clínicos el diagnóstico e iniciar el tratamiento oportuno.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Osteoarticular tuberculosis is a chronic inflammatory disease, very rare, and with an atypical clinical picture and occurs with an incidence of 1-2% of all TB cases.  Objective:  Show a rare form of TB´s presentation in Honduras  Case presentation:  Two-year-old girl with an initial diagnosis of right knee synovitis of five months of evolution and treated with antibiotics and analgesics. Without improvement, she attends to emergencies service with inflammatory changes. Knee x-rays show osteolytic lesions at the kneecap level and the condyle of the right femur. Sputum bacilloscopy and negative tuberculin test were performed. She had a third-grade relative positive to tuberculosis a year and a half ago. A right knee soft tissue and bone biopsies confirm the diagnosis of arthritis by Mycobacterium tuberculosis by immuno-histochemical study with Ziehl Nielsen staining.  Conclusions:  It is the first osteoarticular TB case report in a pediatric patient described in Honduras. Because of the long evolution of the disease, the atypicalness of its clinic features and its low incidence, it is difficult to establish the final diagnosis. Anatomopathological study by biopsy was essential to clarify the diagnosis to clinicians and initiate timely treatment.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[tuberculosis osteoarticular]]></kwd>
<kwd lng="es"><![CDATA[tuberculosis extrapulmonar]]></kwd>
<kwd lng="es"><![CDATA[Mycobacterium tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[osteoarticular tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[extrapulmonary tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[Mycobacterium tuberculosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thomas]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis in Children]]></article-title>
<source><![CDATA[Pediatr Clin North Am]]></source>
<year>2017</year>
<volume>64</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>893-909</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Global Tuberculosis Report. 1997-2020]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lamb]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Starke]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis in Infants and Children]]></article-title>
<source><![CDATA[Microbiol Spectr]]></source>
<year>2017</year>
<volume>5</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez Durán]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno Sanz-Gadea]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Del Rosal Raves]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Mellado Peña]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Baquero-Artigao]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis osteoarticular en la edad pediátrica, revisión de casos en 20 años en un hospital terciario]]></article-title>
<source><![CDATA[An Pediatr (Barc)]]></source>
<year>2017</year>
<volume>87</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>291-2</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carender]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Akoh]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Kowalski]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mycobacterium Tuberculosis Monoarthritis of the Knee in Children A Case Report]]></article-title>
<source><![CDATA[Iowa Orthop J]]></source>
<year>2018</year>
<volume>38</volume>
<page-range>17-23</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Palma]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Islas]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mella]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis monoarticular de la muñeca Comunicación de un caso]]></article-title>
<source><![CDATA[Rev Chilena Infectol]]></source>
<year>2017</year>
<volume>34</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>511-5</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández Pozuelo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez García-Ortega]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Rivas]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Abejón Ortega]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis osteoarticular presentación de 2 casos]]></article-title>
<source><![CDATA[Rev Laborat Clín]]></source>
<year>2013</year>
<volume>6</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>85-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Santiago-García]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Blázquez-Gamero]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Baquero-Artigao]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ruíz-Contreras]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bellón]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Muñoz-Fernández]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric Extrapulmonary Tuberculosis Clinical Spectrum, Risk Factors and Diagnostic Challenges in a Low Prevalence Region]]></article-title>
<source><![CDATA[Pediatr Infect Dis J]]></source>
<year>2016</year>
<volume>35</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1175-81</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agarwal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Paediatric osteoarticular tuberculosis A review]]></article-title>
<source><![CDATA[J Clin Orthop Trauma]]></source>
<year>2020</year>
<volume>11</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>202-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez-López]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Subirá-Álvarez]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez-Ruíz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Noguera-Julián]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno-Romo]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Torner-Rubies]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fontecha]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Non-axial osteoarticular tuberculosis in the paediatric age]]></article-title>
<source><![CDATA[Rev Esp Cir Ortop Traumatol]]></source>
<year>2021</year>
<volume>65</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>186-94</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mascareñas-De Los Santos]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo-Bejarano]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
<name>
<surname><![CDATA[de Cuellar]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Camilo-de Amarante]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Camacho-Badilla]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[López-López]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis in Latin America and its Impact on Pediatrics]]></article-title>
<source><![CDATA[Rev Latinoam Infectol Pediátr]]></source>
<year>2020</year>
<volume>33</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>66-73</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Global tuberculosis report. Annual report]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Aguilo]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gonzalo-Asensio]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vacunación frente a tuberculosis]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2018</year>
<volume>36</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>648-56</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agashe]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
<name>
<surname><![CDATA[Johari]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Anjum]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Romano]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Drago]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosis of Osteoarticular Tuberculosis Perceptions, Protocols, Practices, and Priorities in the Endemic and Non-Endemic Areas of the World-A WAIOT View]]></article-title>
<source><![CDATA[Microorganisms]]></source>
<year>2020</year>
<volume>8</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1312</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agarwal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Agarwal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Needle Aspiration and Cytology for Suspected Osteoarticular Tuberculosis in Children]]></article-title>
<source><![CDATA[Malays Orthop J]]></source>
<year>2018</year>
<volume>12</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>31-7</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Prasad]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Manchanda]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sachdev]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Baruah]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
<name>
<surname><![CDATA[Manchanda]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Imaging features of pediatric musculoskeletal tuberculosis]]></article-title>
<source><![CDATA[Pediatr Radiol]]></source>
<year>2012</year>
<volume>42</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1235-49</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="book">
<collab>Secretaria de Salud Honduras</collab>
<source><![CDATA[Protocolo del manejo de la tuberculosis en pediatría]]></source>
<year>2019</year>
<edition>Primera y única edición</edition>
<publisher-loc><![CDATA[Honduras ]]></publisher-loc>
<publisher-name><![CDATA[Secretaria]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
