Drug-resistant tuberculosis is a global health threat that proves challenging for young children who are difficult to diagnose and treat. However, a rare kind of tuberculosis has been found when a 2-year returned to the United States sick from a visit in India. Standard tests shows negative of tuberculosis but doctors suspect one. Later on, it was found to be an extensively drug-resistant strain of tuberculosis or XDR-TB that is resistant to a list of medicines.
As reported by Washington Post, doctors at Johns Hopkins Children's Center have successfully treated a few kids who suffered this rare kind of tuberculosis in the United States.
Dr. Sanjay Jain, Hopkins Paediatric Tuberculosis Specialist said, "This was so difficult, even when we had all these resources." Dr. Jain also co-authored the report published Monday in The Lancet Infectious Diseases. The said child is now 5 and healthy. However Dr. Jain states it's a wake-up call to the realities of tuberculosis.
With the emergence of this rare kind of tuberculosis, it will prove very difficult to treat youngsters in countries that cannot afford such creative care.
In some parts of the world, health professionals do not have access to medical equipments such as CT scan to aid them to diagnose the disease. Their decisions are limited to stethoscope, scale and their clinical judgement as said by Dr. Anna Mandalakas, director of the global tuberculosis program at Texas Children's Hospital and Baylor College of Medicine.
The youngster who suffered from the rare kind of tuberculosis, who was not identified, returned from a three-month family trip to India with high fever. A number of tests prove fruitless and no other relatives were reported sick. However, CT scans and X-rays showed spots on her lungs and some enlarged lymph nodes.
To diagnose an adult, doctors usually check their sputum for TB germs however children especially those under 5 don't have that much bacteria and they also tend to swallow rather than spit out the mucus, Dr. Jain explains. So they had to thread a tube into the girl's stomach for samples and the lab then tried to grow and identify any bacteria that can be found.
The child was prescribed four standard TB drugs that proved successful in eliminating fever and regaining her appetite. However, X-rays showed persistent lung inflammation and it wasn't after 12 weeks that doctors finally confirmed that she had the scary XDR-TB after the initial exam.
Drug-resistant strains of tuberculosis are increasing especially in India, China and Africa although it is extremely rare to find in the United States.
This very rare case in Hopkins Center proves that children may harbour resistant tuberculosis even if they seem to improve shortly after standard treatment. Research has just started on possible new options for multi-drug resistant tuberculosis.
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