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Duration of anti-tuberculous therapy in children with persistent tuberculomas

Ira Shah1, Naman S Shetty1

  • 1Pediatric TB Clinic, Department of Pediatric Infectious Diseases, Bai Jerbai Wadia Hospital for Children, Mumbai, India.

SAGE Open Medical Case Reports
|January 24, 2019
PubMed

Insights

Treatment for central nervous system tuberculosis tuberculomas may require longer than the standard 1 year. Extended anti-tuberculous therapy duration, based on imaging, can lead to lesion resolution in pediatric cases.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Central nervous system tuberculosis (CNS TB) requires anti-tuberculous therapy (ATT).
  • Standard treatment duration for tuberculomas is typically 1 year.
  • Guidelines for extended ATT in persistent CNS TB tuberculomas are lacking.

Observation:

  • A series of six pediatric CNS TB cases with persistent tuberculomas were analyzed.
  • Patients received ATT for 23–32 months, guided by neuroradiological scan resolution.
  • Treatment response was monitored via changes in granuloma size and number.

Findings:

  • All patients showed a decrease in tuberculoma size and number.
  • One patient achieved complete resolution of lesions.
  • After ATT cessation, granuloma size stabilized in most cases, with one showing an increase.

Implications:

  • Extended ATT duration may be necessary for complete resolution of CNS TB tuberculomas.
  • Treatment duration should be individualized based on patient response and imaging.
  • Further research is needed to establish definitive guidelines for prolonged ATT in CNS TB.

Keywords:
Anti-tuberculous therapychildrentubercular meningitistuberculoma

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