EXPOSURE TO XDR-TB

Dr Ira Shah

doi:10.7199/ped.oncall.2012.75

EXPOSURE TO XDR-TB

Dr Ira Shah.

Medical Sciences Department, Pediatric Oncall, Mumbai.

ADDRESS FOR CORRESPONDANCE
Pediatric Oncall, 1, B Saguna, 271, B St Francis Road, Vile Parle {W}, Mumbai 400056

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Clinical Problem
A 3½ years old girl is in contact with an adult suffering from XDR-TB. Her Mantoux test is also positive. She is otherwise asymptomatic. Her Chest X-Ray is normal

How should this child be treated_?

Discussion
This child has latent TB, is less than 5 years of age and is in contact with an adult having TB. Thus this child should receive prophylaxis for TB. As per WHO, prophylaxis for latent TB is 6 months of INH. However, this child is in contact with an adult having XDR-TB. Thus she may have been exposed to resistant bug. Thus INH may not be protective. There is not enough literature to determine which drug should be given as prophylaxis in such a scenario. The WHO recommends a wait and watch policy in such a situation and to treat the child only when the child becomes symptomatic. There are reports of use of pyrazinamide and ofloxacin prophylaxis in such situations but it is not recommended as you may actually lead to more drug resistance in the child.

Compliance with ethical standards

Funding: None

Conflict of Interest: None

DOI: https://doi.org/10.7199/ped.oncall.2012.75

Cite this article as:
Shah I. EXPOSURE TO XDR-TB. Pediatr Oncall J. 2012;9: 120. doi: 10.7199/ped.oncall.2012.75

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EXPOSURE TO XDR-TB
EXPOSURE TO XDR-TB 24/11/2012 24/11/2012 Ira Shah https://www.pediatriconcall.com/Journal/images/journal_cover.jpg Dr Ira Shah. Medical Sciences Department, Pediatric Oncall, Mumbai. ADDRESS FOR CORRESPONDANCE Pediatric Oncall, 1, B Saguna, 271, B St Francis Road, Vile Parle {W}, Mumbai 400056 Show affiliations
Clinical Problem A 3½ years old girl is in contact with an adult suffering from XDR-TB. Her Mantoux test is also positive. She is otherwise asymptomatic. Her Chest X-Ray is normal

How should this child be treated_?

Discussion This child has latent TB, is less than 5 years of age and is in contact with an adult having TB. Thus this child should receive prophylaxis for TB. As per WHO, prophylaxis for latent TB is 6 months of INH. However, this child is in contact with an adult having XDR-TB. Thus she may have been exposed to resistant bug. Thus INH may not be protective. There is not enough literature to determine which drug should be given as prophylaxis in such a scenario. The WHO recommends a wait and watch policy in such a situation and to treat the child only when the child becomes symptomatic. There are reports of use of pyrazinamide and ofloxacin prophylaxis in such situations but it is not recommended as you may actually lead to more drug resistance in the child.

Compliance with ethical standards
Funding: None
Conflict of Interest: None


DOI: https://doi.org/10.7199/ped.oncall.2012.75

Cite this article as: Shah I. EXPOSURE TO XDR-TB. Pediatr Oncall J. 2012;9: 120. doi: 10.7199/ped.oncall.2012.75