XDR-TB Transmitted from Mother to 10-Month-Old Infant: Diagnostic and Therapeutic Problems.

Drug-resistant TB (DR-TB) in children is a special epidemiological, clinical, and diagnostic problem, and its global incidence remains unknown. DR-TB in children is usually of a primary nature and is most often transmitted to the child from a household contact, so these cases reflect the prevalence of DR-TB in the population of adult patients. The risk of infection with Mycobacterium tuberculosis complex (MTBC) in children depends on age, duration of exposure, proximity of contact with the infected person, and the level of source virulence. Most cases of TB in children, especially in infants, are caused by household contacts, where the main sources of infection are parents, grandparents or older siblings. However, there are many documented cases of TB transmission outside the family. The most common source of infection is an adult who is profusely positive for mycobacteria, diagnosed too late, and inadequately treated. It has been estimated that a sputum-positive patient might infect 30-50% of their household members. For this reason, active epidemiological investigation and contact tracing in the environment of sputum-positive patients are the most appropriate methods of identifying infected family members. This paper presents a case report concerning the transmission of extensively drug-resistant TB, Beijing 265 genotype, from a mother to her 10-month-old daughter. It is the first case diagnosed in Poland, and one of very few described in the literature where treatment was effective in the mother and the infant recovered spontaneously.

Recommendations for the management of tuberculosis in children - KOMPASS TB. Part 1: Tuberculosis prevention.

Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment.

[Erythema nodosum of tuberculous etiology in a 18 months old girl]. / Rumien guzowaty o etiologii gruzliczej u 18-miesiecznej dziewczynki.

The authors report a case of an 18-months old girl with primary tuberculosis, where erythema nodosum was the main symptom. She received BCG vaccination on the first day of life according to the Polish vaccination programme. Although there was no postvaccinal scar when she was 12 months old, she was not revaccinated. On hospitalisation, the tuberculin skin test was strongly positive. The girl had a confirmed contact with tuberculosis. On the base of the anamnestic data and the clinical course, Erythema nodosum of tuberculous etiology was diagnosed and treatment was introduced. Erythema nodosum is not specific for tuberculosis but in the differential diagnosis tuberculosis should be taken into consideration.