Publications in modern literature on tuberculosis and SARS-CoV-2 coinfection in children and adolescents are rare and insufficient. In this paper, we describe a clinical case of tuberculosis and SARS-CoV-2 coinfection in an adolescent child. An uncomplicated course of both diseases was demonstrated.
Parasitic infections are widespread throughout the world and are especially common in childhood. The absence of pathognomonic symptoms in liver diseases is characteristic. We presented clinical observation with asymptomatic echinococcosis with damage to the respiratory organs and liver. During the fluorographic examination, changes in the lungs were revealed, in connection with which she was sent for a consultation with a phthisiatrician. In the TB hospital, with the help of a comprehensive examination and modern telemedicine technologies, changes were identified in lungs and in the liver. This clinical observation showed that it is necessary to conduct a comprehensive examination before prescribing specific anti-tuberculosis treatment. Increasing physicians' knowledge of parasitic diseases could increase the early detection.
Introduction. The treatment of children with multidrug-resistant and extensively drug-resistant tuberculosis (MDR / XDR-TB) is a difficult task due to many factors: the duration of treatment, the lack of drugs with children’s dosages, age restrictions (according to the drug instructions).Purpose of the study. To assess the efficacy and safety of regimen with the inclusion of bedaquiline in children and adolescent with respiratory tuberculosis with drug-resistant tuberculosis.Materials and methods. The study is prospective, cohort, non-comparative from the period 2017–2019. We included 24 patients aged 5 to 17 years with MDR-TB (established or suspected) began regimen containing bedaquiline for 24 weeks. The duration of observation of patients included in the study was 24 months.Results. We can state a sufficient level of safety of using the latter for 24 weeks: adverse events presumably associated directly with the intake of bedaquiline were noted in only 1 patient out of 24 (4.2%; 95% CI 0.7-20.3). The efficacy of a regimen containing bedaquiline in combination with other anti-tuberculosis reserve drugs is beyond doubt: positive clinical and radiological dynamics and cessation of bacterial excretion by the end of the 24-week course of treatment were noted in all patients included in the study. In the course of 2-year follow-up, no exacerbation of the tuberculous process was observed in any case. All patients achieved clinical cure of tuberculosis.Conclusion. Regimen containing bedaquiline for children aged 5–17 years with multidrug-resistant tuberculosis is effective and safe.
During this study, cohorts with the highest risk of tuberculosis needed in detailed examination were defined in the community. A group of 328 patients with local tuberculosis and a group of 1 250 children and adolescents with high risk of tuberculosis were chosen with a method of total cross sectional selection to evaluate efficacy of a new diagnostic method Diaskin test ® using recombinant allergen of M. tuberculosis (protein CFP 10 ESAT6) in a standard solution. Results of this study have led to development of a new technique of diagnosis of tuberculosis, subsequent examination and follow up of high risk groups in a tuberculosis center. Selection criteria for at risk groups have been developed to further diagnosis and follow up by a TB specialist. The highest risk of tuberculosis has been estimated in patients with positive Diaskin test ® and risk factors for tuberculosis. An algorithm of diagnosis and follow up using Diaskin test ® has been proposed.
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