Is it Drug Resistant TB

 
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A 14 months old boy on antituberculous therapy {ATT} since past 3 months had left sided cervical swelling with fever for 15 days. At 11 months of age, he had fever and Mantoux test was positive and he was started on category 3 ATT. Currently he had 2 x 3 cm left cervical adenopathy. Weight was 9.3 kg {which was the same 3 months ago} and height was 79.5 cm. Other systems were normal. Chest X-Ray was normal. He underwent excision drainage of the abscess and ATT was continued. Again a month later, he had another cervical node that increased in size for which excision biopsy was done. Histopathology showed reactive follicular hyperplasia and 4 acid fast bacilli {AFB}. However culture did not grow any AFB. He again developed cervical adenopathy after 1 month.
Expert Opinion :
We started the child on streptomycin and clarithromycin along with 4 drug antituberculous therapy to cover for atypical mycobacteria.
Answer Discussion :
D
DrMohit Kehar
bubble
dead AFB can also have positive ZN , as culture is negative , can be paradoxical reaction
nonTB myco must have some response to ATT

6 years ago
D
DrMohit Kehar
bubble
WHAT About fever and general well bring , appetite .
Check the compliance, can get HIV testing

6 years ago

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