title: Disseminated tuberculosis in an HIV-infected child: rifampicin resistance detected by GeneXpert in a lymph node aspirate but not in cerebrospinal fluid.
abstract: A 9-year-old HIV-infected child previously treated with inadequate doses of antitubercular drugs based on weight was admitted 5 months after initial tuberculosis (TB) diagnosis with acute hemiplegia and inguinal lymphadenopathies in a rural hospital in Tanzania. He was diagnosed with TB meningitis and lymphadenitis using Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay. Rifampicin resistance was detected in the lymph node aspirate but not in the cerebrospinal fluid. His TB therapy was optimised based on available medications and antiretroviral treatment was initiated 6 weeks later. Despite these efforts, the clinical evolution was poor and the child died 12 weeks after admission.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gamell
authors.affiliation: Ifakara Health Institute, Ifakara, United Republic of Tanzania.
authors.forename: Alex John
authors.initials: AJ
authors.lastname: Ntamatungiro
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Emilio
authors.initials: E
authors.lastname: Letang
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D002648:Child; D004269:DNA, Bacterial / Q000032:analysis; D024881:Drug Resistance, Bacterial; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006429:Hemiplegia / Q000209:etiology / Q000382:microbiology; D006801:Humans; D008198:Lymph Nodes; D008199:Lymphadenitis / Q000209:etiology / Q000382:microbiology; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000254:growth & development; D012293:Rifampin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000188:drug therapy / Q000382:microbiology
chemical_list: D019380:Anti-HIV Agents; D000904:Antibiotics, Antitubercular; D004269:DNA, Bacterial; D012293:Rifampin