Drug-resistant TB treated at John Hopkins Children's Center
A 5-year old child with drug-resistant tuberculosis has been successfully treated at John Hopkins Children's Center.
According to the report by US News & World Report, the child got sick after visiting India and took three months to find out that it was a rare form of tuberculosis (TB). It was a drug-resistant TB (XDR-TB) and cases have been popping around India, Africa and China. The details of the child's diagnosis and treatment have been published online at The Lancet Infectious Diseases.
According to the health experts, drug-resistant is difficult to treat because it is caused by several strains of bacteria don't respond to usual drug treatment. Children are also harder to diagnose and treat because they don't have as much TB bacteria as adults and get sick faster.
"Drug-resistant TB is a daunting disease to diagnose and treat in anyone, but in a child, it is infinitely more so," said Dr. Nicole Salazar-Austin, coauthor and fellow at the Johns Hopkins University School of Medicine, via Eureka Alert.
Dr. Sanjay Jain, a TB expert and pediatrician at the hospital, says that lack of proper, effective and fast diagnostic tools made the case difficult. It took them 12 weeks to find out that the girl had drug-resistant TB.
The child returned from India with high fever but despite numerous testing including a throat swab, urine and bloodwork, the results returned negative. A chest x-ray revealed an anomaly on her lung. The patient was then tested via gastric aspiration, which is a method used on kids to analyze mucus from inside the lungs.
According to Health Day, the patient was treated like a regular TB patient and although she had improvements with standard TB treatment, her X-rays revealed persistent lung inflammation and lung tissue that were dying.
Since three out of four medications were not working, doctors had the child on five different experimental drugs. They had no way of tracking down the medicine if they were working or not, so Jain used low-radiation CT-scans to monitor the progress of the therapy. It was revealed that the medicine worked and her lungs were clearing. According to Washington Post, the girl was in remission after a year and a half of treatment.
"We are thrilled that our patient is doing so well," Dr. Jain said in a press release. "But at the same time, this is a wake-up call to the realities of TB."
The Johns Hopkins team will regularly monitor the girl for a couple of years to ensure that the infection will not resurface.