Successful Treatment of U.S. Child With XDR Tuberculosis
(HealthDay News) — A 5-year-old child from the United States, diagnosed at age 2 with extensively drug-resistant (XDR) tuberculosis after traveling to India, is finally in remission, researchers report. A detailed account of the child's diagnosis and treatment, and the obstacles that clinicians at the Johns Hopkins Children's Center in Baltimore faced, was published in the December issue of The Lancet Infectious Diseases.
In this case, the child developed symptoms of fever and malaise after a three month visit to India. Although initial testing came back negative for tuberculosis, her medical team proceeded with empirical first-line tuberculosis treatment. Her condition improved at first, but a repeat X-ray revealed persistent lung inflammation. Repeat lab tests confirmed, after 12 weeks, that she harbored an extensively drug-resistant form of the disease.
The clinical team tried a new cocktail, combining five different drugs plus vitamin B6, and tracked progress by repeatedly administering low-dose computed tomography scans over six months. Symptom improvement was apparent weeks after the scans reflected declining lung inflammation and lower bacterial counts.
"Treatment has been successful so far, and the child is in remission," the authors write. "This report of XDR tuberculosis in a young child in the USA highlights the risks of acquiring drug-resistant tuberculosis overseas, and the unique challenges in management of tuberculosis in this susceptible population."