Question of the Week

Question :
Posted On : 03 Apr 2006
A woman is hiv plus ve. She has delivered 4 days back. Postpartum her tuberculin test is positive. Hence further screened for kochs. On USG she is having abdominal lymphadenopathy with splenic microabscesses. Physician says that it is a case of abdominal kochs. Sputum is negative. CHEST X-RAY IS NOT SUGGESTIVE OF pulmonary kochs. Physician says that though it is not a open case, it can be disseminated kochs and sputum report can be false negative. Should we start prophylactic antitubercular therapy to the baby considering it as a case of contact. Mother is going to breast feed the baby. We have similar case i.e. similar finding but whose afb culture came positive 3 weeks later.
5
Expert Answer :
No expert answer available.
Answer Discussion :
M
mohini
Profile
yes the above treatment protocol is correct.This case can turn afb Plus ve later.prophylactic antitubercular therapy should be given to the baby as it is breastfeeding.
19 years ago
P
pediatriconcall
Profile
If a pregnant woman with active pulmonary tuberculosis is sputum negative during the last three months of gestation, the risk to infant is negligible. However since the mother is HIV infected and has abdominal kochs with splenic microabscesses, then she may have occult pulmonary TB that may be not seen on the Xray chest in an immunosuppressed state. In such a situation, it would be better to screen the child for TB by doing an Xray chest and a Mantoux test and if suggestive of TB, AKT would be needed. If negative, one may consider INH prophylaxis for the child in view of strong suspicion.
19 years ago
P
prathiba pai
Profile
yes
19 years ago
N
Narendra Chhablani
Profile
Prophylactic ATT to baby should be given conidering to known HIV status and strong possibility of extra pulmonary tuberculosis in the mother .
19 years ago
N
nikhil agrawal
Profile
Check for HIV status of the baby,Give INH prophylaxis.If HIV negative, immunize with BCG.
19 years ago




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