Child with drug-resistant TB successfully treated in US

Doctors in US, including one of Indian-origin, have successfully treated a two-year-old child suffering from a highly virulent form of drug resistant tuberculosis who had returned sick from a visit to India.
Specialists at the Johns Hopkins Children's Centre in US treated and put in remission the unidentified child, now aged five, suffering from extensively drug-resistant TB (XDR TB) by using a 'cocktail' of drugs, and CT scans to monitor progress.
The bug's resistance to most known TB drugs makes it difficult to treat, especially in children, with only a handful of cases of children younger than five described in the medical literature worldwide, the researchers said.

"We are thrilled that our patient is doing so well," said Sanjay Jain, a pediatrician and TB expert at the Johns Hopkins Children's Centre.
"But at the same time, this is a wake-up call to the realities of TB," Jain said.
Mycobacterium tuberculosis, the bacterium responsible for TB, is estimated to cause almost 10 million new cases of TB disease worldwide each year, with strains impervious to drug therapies rapidly spreading, researchers said.

Experts estimate that a million children develop TB each year, but the real number may be higher given the difficulty of confirming the diagnosis in a child.

Children with TB harbour far fewer TB bacteria in their bodies than adults, which can render initial test results inconclusive, cause a false negative reading and lead to substantial delays in diagnosis, Jain said.
Diagnosis can be further complicated by unreliable laboratory techniques that may take weeks to yield definitive results.
The child was brought to hospital for evaluation of unrelenting fever and malaise upon her return from India, where she and a sibling spent three months.
Even though initial test results for infection came back negative, the pediatricians forged ahead with preemptive treatment for TB anyway.
Repeat lab tests ultimately showed the child harboured XDR TB. In all, conclusive identification of drug-resistant TB took 12 weeks, the researchers said.