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.
2015 BMJ Publishing Group Ltd.
MeSH terms
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Anti-HIV Agents / therapeutic use
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Antibiotics, Antitubercular* / therapeutic use
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Child
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DNA, Bacterial / analysis
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Drug Resistance, Bacterial*
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Fatal Outcome
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HIV Infections / complications*
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HIV Infections / drug therapy
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Hemiplegia / etiology
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Hemiplegia / microbiology
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Humans
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Lymph Nodes*
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Lymphadenitis / etiology
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Lymphadenitis / microbiology
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Male
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Meningitis / etiology
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Meningitis / microbiology
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Mycobacterium tuberculosis* / drug effects
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Mycobacterium tuberculosis* / genetics
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Mycobacterium tuberculosis* / growth & development
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Rifampin* / therapeutic use
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Tuberculosis, Multidrug-Resistant* / complications
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Tuberculosis, Multidrug-Resistant* / drug therapy
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Tuberculosis, Multidrug-Resistant* / microbiology
Substances
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Anti-HIV Agents
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Antibiotics, Antitubercular
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DNA, Bacterial
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Rifampin