TY - JOUR
T1 - Extensively drug-resistant tuberculosis in a young child after travel to India
AU - Salazar-Austin, Nicole
AU - Ordonez, Alvaro A.
AU - Hsu, Alice Jenh
AU - Benson, Jane E.
AU - Mahesh, Mahadevappa
AU - Menachery, Elizabeth
AU - Razeq, Jafar H.
AU - Salfinger, Max
AU - Starke, Jeffrey R.
AU - Milstone, Aaron M.
AU - Parrish, Nicole
AU - Nuermberger, Eric L.
AU - Jain, Sanjay K.
N1 - Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Extensively drug-resistant (XDR) tuberculosis is becoming increasingly prevalent worldwide, but little is known about XDR tuberculosis in young children. In this Grand Round we describe a 2-year-old child from the USA who developed pneumonia after a 3 month visit to India. Symptoms resolved with empirical first-line tuberculosis treatment; however, a XDR strain of Mycobacterium tuberculosis grew in culture. In the absence of clinical or microbiological markers, low-radiation exposure pulmonary CT imaging was used to monitor treatment response, and guide an individualised drug regimen. Management was complicated by delays in diagnosis, uncertainties about drug selection, and a scarcity of child-friendly formulations. Treatment has been successful so far, and the child is in remission. This report of XDR tuberculosis in a young child in the USA highlights the risks of acquiring drug-resistant tuberculosis overseas, and the unique challenges in management of tuberculosis in this susceptible population.
AB - Extensively drug-resistant (XDR) tuberculosis is becoming increasingly prevalent worldwide, but little is known about XDR tuberculosis in young children. In this Grand Round we describe a 2-year-old child from the USA who developed pneumonia after a 3 month visit to India. Symptoms resolved with empirical first-line tuberculosis treatment; however, a XDR strain of Mycobacterium tuberculosis grew in culture. In the absence of clinical or microbiological markers, low-radiation exposure pulmonary CT imaging was used to monitor treatment response, and guide an individualised drug regimen. Management was complicated by delays in diagnosis, uncertainties about drug selection, and a scarcity of child-friendly formulations. Treatment has been successful so far, and the child is in remission. This report of XDR tuberculosis in a young child in the USA highlights the risks of acquiring drug-resistant tuberculosis overseas, and the unique challenges in management of tuberculosis in this susceptible population.
UR - http://www.scopus.com/inward/record.url?scp=84960413216&partnerID=8YFLogxK
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U2 - 10.1016/S1473-3099(15)00356-4
DO - 10.1016/S1473-3099(15)00356-4
M3 - Review article
C2 - 26607130
AN - SCOPUS:84960413216
SN - 1473-3099
VL - 15
SP - 1485
EP - 1491
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 12
ER -