Cargando…
A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis
BACKGROUND: There are unique challenges in the diagnosis and management of multi drug resistant tuberculosis (MDR-TB) in children. It is difficult to obtain confirmatory microbiological diagnosis in TB pericarditis. It is essential to differentiate between drug sensitive and drug resistant forms of...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178721/ https://www.ncbi.nlm.nih.gov/pubmed/32321429 http://dx.doi.org/10.1186/s12879-020-05027-1 |
_version_ | 1783525521884184576 |
---|---|
author | Swaminathan, Aravind du Cros, Philipp Achar, Jay Kliescikova, Jarmila Mirgayosieva, Shamsiya Pirmahmadzoda, Bobojon |
author_facet | Swaminathan, Aravind du Cros, Philipp Achar, Jay Kliescikova, Jarmila Mirgayosieva, Shamsiya Pirmahmadzoda, Bobojon |
author_sort | Swaminathan, Aravind |
collection | PubMed |
description | BACKGROUND: There are unique challenges in the diagnosis and management of multi drug resistant tuberculosis (MDR-TB) in children. It is difficult to obtain confirmatory microbiological diagnosis in TB pericarditis. It is essential to differentiate between drug sensitive and drug resistant forms of TB as it has a major bearing on the regimen used, and inappropriate TB treatment combined with steroid use for pericarditis can lead to deterioration. With lack of samples, the treatment decision relies on the drug resistance pattern of the close contact if available. Therapeutic challenges of MDR-TB management in a child involve use of toxic drugs that need to be judiciously handled. We report a 2 years 4 months old male child who was diagnosed with TB pericarditis and treated based on the resistance pattern of his mother who was on treatment for pulmonary MDR-TB. CASE PRESENTATION: This 2 years 4 months old male child was diagnosed with TB involving his pericardium. Getting him started on an appropriate regimen was delayed due to the difficulty in establishing microbiological confirmation and drug susceptibility. He was commenced on a regimen based on his mother’s drug resistance pattern and required surgery due to cardiac failure during the course of his treatment. He successfully completed 2 years of therapy. CONCLUSIONS: This child’s case demonstrates that despite unique challenges in diagnosis and management of drug resistant extra pulmonary tuberculosis in children, treatment of even complex forms can be successful. The need for high suspicion of MDR-TB, especially when there is close contact with pulmonary TB, careful design of an effective regimen that is tolerated by the child, indications for invasive surgical management of pericarditis, appropriate follow-up and management of adverse effects are emphasised. |
format | Online Article Text |
id | pubmed-7178721 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71787212020-04-26 A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis Swaminathan, Aravind du Cros, Philipp Achar, Jay Kliescikova, Jarmila Mirgayosieva, Shamsiya Pirmahmadzoda, Bobojon BMC Infect Dis Case Report BACKGROUND: There are unique challenges in the diagnosis and management of multi drug resistant tuberculosis (MDR-TB) in children. It is difficult to obtain confirmatory microbiological diagnosis in TB pericarditis. It is essential to differentiate between drug sensitive and drug resistant forms of TB as it has a major bearing on the regimen used, and inappropriate TB treatment combined with steroid use for pericarditis can lead to deterioration. With lack of samples, the treatment decision relies on the drug resistance pattern of the close contact if available. Therapeutic challenges of MDR-TB management in a child involve use of toxic drugs that need to be judiciously handled. We report a 2 years 4 months old male child who was diagnosed with TB pericarditis and treated based on the resistance pattern of his mother who was on treatment for pulmonary MDR-TB. CASE PRESENTATION: This 2 years 4 months old male child was diagnosed with TB involving his pericardium. Getting him started on an appropriate regimen was delayed due to the difficulty in establishing microbiological confirmation and drug susceptibility. He was commenced on a regimen based on his mother’s drug resistance pattern and required surgery due to cardiac failure during the course of his treatment. He successfully completed 2 years of therapy. CONCLUSIONS: This child’s case demonstrates that despite unique challenges in diagnosis and management of drug resistant extra pulmonary tuberculosis in children, treatment of even complex forms can be successful. The need for high suspicion of MDR-TB, especially when there is close contact with pulmonary TB, careful design of an effective regimen that is tolerated by the child, indications for invasive surgical management of pericarditis, appropriate follow-up and management of adverse effects are emphasised. BioMed Central 2020-04-22 /pmc/articles/PMC7178721/ /pubmed/32321429 http://dx.doi.org/10.1186/s12879-020-05027-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Swaminathan, Aravind du Cros, Philipp Achar, Jay Kliescikova, Jarmila Mirgayosieva, Shamsiya Pirmahmadzoda, Bobojon A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title | A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title_full | A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title_fullStr | A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title_full_unstemmed | A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title_short | A case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with DR-TB pericarditis |
title_sort | case report of a child with probable drug resistant tuberculous pericarditis with a review of challenges involved in diagnosis, treatment and follow up of children with dr-tb pericarditis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178721/ https://www.ncbi.nlm.nih.gov/pubmed/32321429 http://dx.doi.org/10.1186/s12879-020-05027-1 |
work_keys_str_mv | AT swaminathanaravind acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT ducrosphilipp acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT acharjay acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT kliescikovajarmila acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT mirgayosievashamsiya acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT pirmahmadzodabobojon acasereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT swaminathanaravind casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT ducrosphilipp casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT acharjay casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT kliescikovajarmila casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT mirgayosievashamsiya casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis AT pirmahmadzodabobojon casereportofachildwithprobabledrugresistanttuberculouspericarditiswithareviewofchallengesinvolvedindiagnosistreatmentandfollowupofchildrenwithdrtbpericarditis |