Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report
Abstract Background Tuberculosis remains a major cause of morbidity and mortality worldwide, especially in developing countries. The diagnosis and treatment of multi-drug resistant tuberculosis (MDR-TB) in children remain a major limitation in this setting, largely due to difficulties in isolating M...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Research Notes |
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| Online Access: | http://link.springer.com/article/10.1186/s13104-018-3148-5 |
| _version_ | 1818790478284324864 |
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| author | Christelle Géneviève Jouego Valirie Ndip Agbor Juergen Noeske Ndo Akono Manuel Leo Njock Ayuk |
| author_facet | Christelle Géneviève Jouego Valirie Ndip Agbor Juergen Noeske Ndo Akono Manuel Leo Njock Ayuk |
| author_sort | Christelle Géneviève Jouego |
| collection | DOAJ |
| description | Abstract Background Tuberculosis remains a major cause of morbidity and mortality worldwide, especially in developing countries. The diagnosis and treatment of multi-drug resistant tuberculosis (MDR-TB) in children remain a major limitation in this setting, largely due to difficulties in isolating Mycobacterium tuberculosis from pediatric specimens, management with toxic second line drugs, and practically the inexistence of contact tracing. In 2016, the World Health Organization (WHO) recommended a standardized 9-month regimen for adults and children in zones which are highly endemic for the human immunodeficiency virus (HIV). Herein, we present a case of pediatric MDR-TB/HIV co-infection highlighting the difficulties in treatment and the importance of contact tracing. Case presentation A 6-year old male infant from the West Region of Cameroon infected with HIV who presented at a local health center with a 10 days history of productive cough associated with nocturnal fever and abdominal pains non responsive to broad spectrum antibiotics. A sputum sample analysis requested was smear positive for acid-fast bacilli, and he was initiated on quadritherapy for drug sensitive pulmonary tuberculosis. Since he was a household contact of the mother who was being managed in a referral hospital for MDR-TB at 1 month of treatment, and given his critical clinical situation, a gastric aspirate was repeated and sent for Xpert MTB/RIF to the Tuberculosis Reference Laboratory which was positive for a Rifampicin resistant strain of M. tuberculosis. The short 9 months regimen against MDR-TB was then initiated. During the course of his management, he developed minor side effects of the drugs which were managed symptomatically. Conclusion Even though pediatric MDR-TB is difficult to confirm, it can be treated with favorable clinical outcomes using the short regimen recommended by the WHO. Experts involved in the control of tuberculosis over the national territory should consider adopting routine contact tracing for all cases of tuberculosis particularly amongst children. |
| first_indexed | 2024-12-18T14:56:06Z |
| format | Article |
| id | doaj.art-7e014b8545914c658d5b98e85de5e505 |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-18T14:56:06Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-7e014b8545914c658d5b98e85de5e5052022-12-21T21:04:03ZengBMCBMC Research Notes1756-05002018-01-011111510.1186/s13104-018-3148-5Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case reportChristelle Géneviève Jouego0Valirie Ndip Agbor1Juergen Noeske2Ndo Akono Manuel3Leo Njock Ayuk4Tuberculosis Reference Laboratory BamendaIbal Sub-divisional HospitalConsultant at the National Tuberculosis ProgramBamenda Regional HospitalBamenda Regional HospitalAbstract Background Tuberculosis remains a major cause of morbidity and mortality worldwide, especially in developing countries. The diagnosis and treatment of multi-drug resistant tuberculosis (MDR-TB) in children remain a major limitation in this setting, largely due to difficulties in isolating Mycobacterium tuberculosis from pediatric specimens, management with toxic second line drugs, and practically the inexistence of contact tracing. In 2016, the World Health Organization (WHO) recommended a standardized 9-month regimen for adults and children in zones which are highly endemic for the human immunodeficiency virus (HIV). Herein, we present a case of pediatric MDR-TB/HIV co-infection highlighting the difficulties in treatment and the importance of contact tracing. Case presentation A 6-year old male infant from the West Region of Cameroon infected with HIV who presented at a local health center with a 10 days history of productive cough associated with nocturnal fever and abdominal pains non responsive to broad spectrum antibiotics. A sputum sample analysis requested was smear positive for acid-fast bacilli, and he was initiated on quadritherapy for drug sensitive pulmonary tuberculosis. Since he was a household contact of the mother who was being managed in a referral hospital for MDR-TB at 1 month of treatment, and given his critical clinical situation, a gastric aspirate was repeated and sent for Xpert MTB/RIF to the Tuberculosis Reference Laboratory which was positive for a Rifampicin resistant strain of M. tuberculosis. The short 9 months regimen against MDR-TB was then initiated. During the course of his management, he developed minor side effects of the drugs which were managed symptomatically. Conclusion Even though pediatric MDR-TB is difficult to confirm, it can be treated with favorable clinical outcomes using the short regimen recommended by the WHO. Experts involved in the control of tuberculosis over the national territory should consider adopting routine contact tracing for all cases of tuberculosis particularly amongst children.http://link.springer.com/article/10.1186/s13104-018-3148-5Contact tracingPediatric multi-drug resistant tuberculosisXpert MTB/RIFCase reportCameroon |
| spellingShingle | Christelle Géneviève Jouego Valirie Ndip Agbor Juergen Noeske Ndo Akono Manuel Leo Njock Ayuk Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report BMC Research Notes Contact tracing Pediatric multi-drug resistant tuberculosis Xpert MTB/RIF Case report Cameroon |
| title | Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report |
| title_full | Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report |
| title_fullStr | Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report |
| title_full_unstemmed | Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report |
| title_short | Pediatric multi-drug resistant-tuberculosis and HIV co-infection in a resource—limited setting: a case report |
| title_sort | pediatric multi drug resistant tuberculosis and hiv co infection in a resource limited setting a case report |
| topic | Contact tracing Pediatric multi-drug resistant tuberculosis Xpert MTB/RIF Case report Cameroon |
| url | http://link.springer.com/article/10.1186/s13104-018-3148-5 |
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