Innes Steve, Schaaf H Simon, Hoek Kim Gp, Rabie Helena, Cotton Mf
KID-CRU (Children's Infectious Diseases Clinical Research Unit), Tygerberg Children's Hospital and Stellenbosch University.
South Afr J Epidemiol Infect. 2010;25(2):30-32.
We report a case of rapidly progressive miliary tuberculosis in a 21-month old HIV-infected girl exposed to tuberculosis, despite early access to highly active antiretroviral therapy and proven adherence to isoniazid chemoprophylaxis. Post mortem revealed multidrug-resistant tuberculosis. This case report illustrates the consequences of inadequate programmatic management of children exposed to an adult case of sputum smear-positive multidrug-resistant tuberculosis. Drug susceptibility testing of the adult source case should become standard of care for all children who have been in close contact with a case of sputum smear-positive tuberculosis, and the choice of chemoprophylactic agents should be based on the sensitivities of the source case organism.
我们报告了一例21个月大感染HIV且接触过结核病的女童发生快速进展性粟粒型肺结核的病例，尽管其早期即接受了高效抗逆转录病毒治疗且已证实坚持服用异烟肼进行化学预防。尸检显示为耐多药结核病。本病例报告说明了对接触成人痰涂片阳性耐多药结核病病例的儿童进行规划管理不足所产生的后果。对成人源病例进行药敏试验应成为所有接触过痰涂片阳性结核病病例儿童的标准治疗措施，化学预防药物的选择应基于源病例病原体的敏感性。
