The Lancet Infectious Disease

This 5-year old survivor is still healthy to this day

Scienents give a inside view on...

Caused by the bacteria Mycobacterium tuberculosis, tuberculosis (TB) is estimated to cause illness among more than 10 million people worldwide each year, and around 1.5 million die from the disease annually.

TB is an airborne disease that most commonly attacks the lungs, causing coughing - including coughing up blood - chest pain, weakness or fatigue, fever, chills, night sweats, loss of appetite and weight loss. If untreated, TB can be fatal.

What's it like having to treat a child with TB?

Yes, TB is a curable disease but it's becoming increasingly challenging to treat, because M. tuberculosis is resistant to most drugs used to treat it.

Report author Dr. Sanjay Jain - TB expert and pediatrician at Johns Hopkins Children's Center - notes that while drug-resistant TB is difficult to treat in general, it is particularly challenging to treat in children.

They explain that children have less TB bacteria in their bodies than adults, which makes the disease tricky to detect and delays diagnosis.

After returning from a 3-month trip to India, the 2-year-old child was brought to Johns Hopkins Hospital with relentless fever and general sickness.

Initial tests - including urine and blood tests and a throat swab - showed no signs of infection. However, a chest X-ray showed the child had a suspicious spot on her lung, prompting further examination.

Doctors then conducted a gastric aspiration, which involves removing swallowed mucus from the gut for testing. While the tests came back negative for TB, the doctors decided to proceed with treatment for the disease.

So what did we do to fix this?

Clinical symptoms would be a poor indicator of treatment response, the doctors reasoned, and lab tests would take weeks - time they did not have, since the child's condition was rapidly worsening. As such, they turned to child-friendly, low-dose CT scans - a technique that is becoming more widely used for children.