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[Tuberculosis: a forgotten challenge]

P Martins1, A Machado, A D Alves

  • 1Serviço de Pediatria, Hospital Distrital de Cascais.

Acta Medica Portuguesa
|June 1, 1997
PubMed
Summary
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This case study highlights a vulnerable child with disseminated, multidrug-resistant tuberculosis (MDR-TB). The severe illness and complications underscore the risks of TB transmission from adults to children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculosis (TB) remains a significant global health challenge despite over a century since its causative agent's discovery.
  • Pediatric TB, particularly disseminated forms, presents unique diagnostic and therapeutic difficulties.

Observation:

  • A case of a 3.5-month-old infant hospitalized with fever, malnutrition, opisthotonos, and hepatosplenomegaly is presented.
  • The infant was diagnosed with disseminated tuberculosis affecting the central nervous system.

Findings:

  • Treatment with five antituberculosis drugs and corticosteroids was initiated, with initial respiratory improvement.
  • The patient developed a seizure, hydrocephalus requiring a shunt, and gastric aspirate revealed Mycobacterium tuberculosis resistant to isoniazid and streptomycin.

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  • At eight months, the child exhibited severe psychomotor retardation, ongoing treatment with three drugs, and the presence of a shunt.

    • Implications:

    • This case underscores the vulnerability of children in high-risk groups to severe, multidrug-resistant tuberculosis (MDR-TB).
    • It highlights the critical need for early diagnosis and effective treatment strategies for pediatric TB.
    • The case illustrates the potential for TB transmission from infected adults to vulnerable infants within families.