Extensively drug-resistant tuberculosis in a young child after travel to India

Nicole Salazar-Austin, Alvaro A. Ordonez, Alice Jenh Hsu, Jane E. Benson, Mahadevappa Mahesh, Elizabeth Menachery, Jafar H. Razeq, Max Salfinger, Jeffrey R. Starke, Aaron M. Milstone, Nicole Parrish, Eric L. Nuermberger, Sanjay K. Jain

Research output: Contribution to journalReview articlepeer-review


Extensively drug-resistant (XDR) tuberculosis is becoming increasingly prevalent worldwide, but little is known about XDR tuberculosis in young children. In this Grand Round we describe a 2-year-old child from the USA who developed pneumonia after a 3 month visit to India. Symptoms resolved with empirical first-line tuberculosis treatment; however, a XDR strain of Mycobacterium tuberculosis grew in culture. In the absence of clinical or microbiological markers, low-radiation exposure pulmonary CT imaging was used to monitor treatment response, and guide an individualised drug regimen. Management was complicated by delays in diagnosis, uncertainties about drug selection, and a scarcity of child-friendly formulations. Treatment has been successful so far, and the child is in remission. This report of XDR tuberculosis in a young child in the USA highlights the risks of acquiring drug-resistant tuberculosis overseas, and the unique challenges in management of tuberculosis in this susceptible population.

Original languageEnglish (US)
Pages (from-to)1485-1491
Number of pages7
JournalThe Lancet Infectious Diseases
Issue number12
StatePublished - Dec 1 2015

ASJC Scopus subject areas

  • Infectious Diseases


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