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Extensively drug-resistant tuberculosis in a young child after travel to India

Nicole Salazar-Austin1, Alvaro A Ordonez2, Alice Jenh Hsu3

  • 1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

The Lancet. Infectious Diseases
|November 27, 2015
PubMed

Insights

Extensively drug-resistant tuberculosis (XDR-TB) in a young child, acquired overseas, presents unique management challenges. Early diagnosis and tailored treatment are crucial for successful outcomes in this vulnerable population.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Global health

Background:

  • Extensively drug-resistant tuberculosis (XDR-TB) is a growing global health concern.
  • Limited data exists on XDR-TB management in young children, a particularly vulnerable demographic.

Observation:

  • A 2-year-old child developed XDR-TB after travel to India.
  • Pulmonary CT imaging guided treatment in the absence of clear clinical or microbiological markers.
  • Management was complicated by diagnostic delays and limited pediatric drug formulations.

Findings:

  • An extensively drug-resistant strain of Mycobacterium tuberculosis was identified.
  • Individualized treatment guided by low-radiation CT imaging led to successful remission.
  • The case underscores the risk of acquiring drug-resistant tuberculosis during international travel.

Implications:

  • Highlights the need for increased awareness and surveillance of XDR-TB in children, especially those with travel history.
  • Emphasizes the importance of developing child-friendly drug formulations for effective TB treatment.
  • Demonstrates the utility of advanced imaging in managing complex pediatric infectious diseases.

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