Is it Drug Resistant TB
Author:
Pediatric Oncall
Question
A 14 months old boy on antituberculous therapy {ATT} since past 3 months had left sided cervical swelling with fever for 15 days. At 11 months of age, he had fever and Mantoux test was positive and he was started on category 3 ATT. Currently he had 2 x 3 cm left cervical adenopathy. Weight was 9.3 kg {which was the same 3 months ago} and height was 79.5 cm. Other systems were normal. Chest X-Ray was normal. He underwent excision drainage of the abscess and ATT was continued. Again a month later, he had another cervical node that increased in size for which excision biopsy was done. Histopathology showed reactive follicular hyperplasia and 4 acid fast bacilli {AFB}. However culture did not grow any AFB. He again developed cervical adenopathy after 1 month.
Is it paradoxical reaction or is it non-mycobacterial TB_?
Expert Opinion :
There is no fever, child is growing well. HIV is negative.