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J Clin Med. 2018 Oct 29;7(11). pii: E397. doi: 10.3390/jcm7110397.

An Infant with Xpert® Confirmed TB Meningitis in Central Viet Nam.

Author information

1
Respiratory Department, Da Nang Hospital for Women and Children, 402 Le Van Hien Street, Ngu Hanh Son District, Da Nang 550000, Viet Nam. thng5150@uni.sydney.edu.au.
2
Discipline of Paediatrics and Adolescent Medicine, The Children's Hospital at Westmead, The University of Sydney, Westmead 2145, Australia. thng5150@uni.sydney.edu.au.
3
Intensive care unit, Da Nang Hospital for Women and Children, 402 Le Van Hien Street, Ngu Hanh Son District, Da Nang 550000, Viet Nam. trangthai_126@yahoo.com.
4
Discipline of Paediatrics and Adolescent Medicine, The Children's Hospital at Westmead, The University of Sydney, Westmead 2145, Australia. Julie.Huynh@health.nsw.gov.au.
5
Department of Infectious diseases and Microbiology, The Children's Hospital at Westmead, Westmead 2145, Australia. Julie.Huynh@health.nsw.gov.au.
6
Discipline of Paediatrics and Adolescent Medicine, The Children's Hospital at Westmead, The University of Sydney, Westmead 2145, Australia. ben.marais@health.nsw.gov.au.
7
Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead 2145, Australia. ben.marais@health.nsw.gov.au.

Abstract

A 5-month-old boy presented with a focal seizure. Disseminated (miliary) tuberculosis (TB) was diagnosed on chest radiograph and TB meningitis was confirmed using Xpert MTB/RIF®. The case represents the first instance of cerebrospinal fluid Xpert MTB/RIF® testing in children in central Viet Nam. Family screening diagnosed the father with sputum smear-positive TB. The mother and a 2-year-old sibling had no symptoms or signs of TB disease and started preventive therapy. Early TB meningitis diagnosis is the single most important factor influencing clinical outcome, but is difficult due to the non-specific signs and symptoms at disease onset. Late diagnosis is associated with high mortality and severe neurologic handicap, which emphasizes the value of TB preventive therapy in vulnerable young children in close contact with an infectious TB case (recent is generally defined as within the last 12 months).

KEYWORDS:

disseminated tuberculosis; miliary; tuberculosis; tuberculous meningitis

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