UNSUSPECTED FATAL DRUG-RESISTANT TUBERCULOSIS IN A CLOSELY MONITORED CHILD: A PLEA FOR IMPROVED SOURCE-CASE TRACING AND DRUG SUSCEPTIBILITY TESTING.
We report a case of rapidly progressive miliary tuberculosis in a 21-month old HIV-infected girl exposed to tuberculosis, despite early access to highly active antiretroviral therapy and proven adherence to isoniazid chemoprophylaxis. Post mortem revealed multidrug-resistant tuberculosis. This case report illustrates the consequences of inadequate programmatic management of children exposed to an adult case of sputum smear-positive multidrug-resistant tuberculosis. Drug susceptibility testing of the adult source case should become standard of care for all children who have been in close contact with a case of sputum smear-positive tuberculosis, and the choice of chemoprophylactic agents should be based on the sensitivities of the source case organism.
Innes
Steve
S
KID-CRU (Children's Infectious Diseases Clinical Research Unit), Tygerberg Children's Hospital and Stellenbosch University.
Schaaf
H Simon
HS
Hoek
Kim Gp
KG
Rabie
Helena
H
Cotton
Mf
M