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Rifampicin-Resistant Tuberculosis in a Toddler: A Report of a Rare Paediatric Case in Obafemi Awolowo University

S S Edward1, J I Akande1, P O Obiajunwa2

  • 1Department of Paediatrics, Paediatric Gastroenterology/Nutrition Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Nigerian Medical Journal : Journal of the Nigeria Medical Association
|January 25, 2021
PubMed

Insights

Rifampicin resistance (RR) in tuberculosis (TB) is a marker for multidrug-resistant TB (MDR-TB). This case highlights a rare pediatric RR-TB in Nigeria, emphasizing challenges in management and parental compliance.

Area of Science:

  • Microbiology
  • Pediatrics
  • Infectious Diseases

Background:

  • Antituberculous drug resistance complicates Mycobacterium tuberculosis (TB) management.
  • Rifampicin resistance (RR) often indicates multidrug-resistant TB (MDR-TB), posing significant treatment challenges.
  • Pediatric RR/MDR-TB is infrequently reported, especially in regions like Nigeria.

Observation:

  • A 2-year-old Nigerian girl presented with prolonged fever, cough, dyspnea, and weight loss.
  • Diagnostic workup, including GeneXpert MTB/RIF on gastric washout, confirmed RR-TB.
  • No known TB contact or prior treatment history was reported for the patient or her parents.

Findings:

  • The case represents a rare instance of pediatric RR-TB diagnosed in the hospital.
  • GeneXpert MTB/RIF confirmed rifampicin resistance, a surrogate for MDR-TB.
  • The patient's parents declined TB screening and follow-up treatment referral.

Implications:

  • Young children are vulnerable to developing complex drug-resistant TB.
  • Management of pediatric RR/MDR-TB requires specialized care, longer treatment, and addresses potential toxicity.
  • Poor parental compliance presents a significant barrier to successful treatment outcomes in pediatric drug-resistant TB cases.

Keywords:
Ile-IfeNigeriarifampicin-resistanttoddlertuberculosis

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