Tuberculosis screening after detection of a case in a paediatric haemato-oncology unit in a low prevalence country

Carlos Daniel Grasa Lozano; María Baro-Fernández; Alba Rubio-San-Simón; Daniel Blázquez-Gamero; Paula López-Roa; Constanza Liébana; Pilar Guerra-García; Cinta Moraleda; Cristina Epalza

doi:10.1016/j.eimc.2020.12.017

Tuberculosis screening after detection of a case in a paediatric haemato-oncology unit in a low prevalence country

Enferm Infecc Microbiol Clin (Engl Ed). 2021 Feb 21:S0213-005X(21)00022-7. doi: 10.1016/j.eimc.2020.12.017. Online ahead of print.

[Article in English, Spanish]

Authors

Carlos Daniel Grasa Lozano¹, María Baro-Fernández², Alba Rubio-San-Simón², Daniel Blázquez-Gamero³, Paula López-Roa⁴, Constanza Liébana⁵, Pilar Guerra-García², Cinta Moraleda³, Cristina Epalza³

Affiliations

¹ Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Spain; Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario La Paz, Madrid, Spain. Electronic address: [email protected].
² Paediatric Haemato-Oncology Unit, Department of Paediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.
³ Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Spain.
⁴ Microbiology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.
⁵ Paediatric Radiology Unit, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.

PMID: 33627247
DOI: 10.1016/j.eimc.2020.12.017

Abstract

Background: There are no guidelines to screen haemato-oncologic children when a tuberculosis (TB) outbreak is suspected.

Methods: After exposition to an adult with active TB, children exposed from a haemato-oncology unit were screened according to immunosuppression status and time of exposure. Until an evaluation after 8-12 weeks from last exposure, isoniazid was indicated to those with negative initial work-up.

Results: After 210 interventions, we detected a case of pulmonary TB, and another with latent TB infection. Pulmonary findings and treatment approach were challenging in some patients.

Conclusions: The TB screening of oncologic children required a multidisciplinary approach, and clinicians managed challenging situations.

Keywords: Cribado; Haemato-oncology; Hematooncología; Pacientes pediátricos; Paediatrics; Screening; Tuberculosis.