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Abstract Ref Number = APCP1192
Poster Presentation
A Positive Acid-Fast Bacillus and GeneXpert TB Sputum Examination in 8 Months-Old Boy with HIV
Chaliza Adnan,Ayu Setyorini,Ida Bagus Subanada,Ni Putu Siadi Purniti
Department of child health medical school of Udayana university Sanglah Hospital
Background : Tuberculosis (TB) is still a health problem that requires special attention, due to high morbidity and mortality rates. TB in children is often misdiagnosed due to difficulties to confirm the microorganism microbiologically. Unlike TB in adult, most of TB diagnoses in children are based solely on clinical features. Additionally, the diagnosis of TB in children who also suffered from Human Immunodeficiency Virus (HIV) and malnutrition was compounded by the similarity of the symptoms, so a diagnosis based on clinical features alone is unreliable in this kind of case
Case Presentation Summary : An 8-month-old boy was diagnosed with stage IV HIV infection and malnutrition. We do Mantoux test that revealed negative results although chest x-ray showed a feature of pulmonary TB that consist of fibroinfiltrat on left suprahiller, parahiller and left right paracardial, increased bronchovascular pattern, suspicious specific process. TB score was obtained only 5 points which consist of TB contact is unknown (score 0), tuberculine skin test is negative (score 0), malnutrition (score 2), fever >2 weeks (score 1), chonic cough is negative (score 0), lymphadenophaty is positive (score 1), and the thoracic x-ray showed TB sugestive (score 1). Since 3 months old, the boy has performed the examination of sputum acid-fast bacillus (AFB) and GeneXpert TB using sputum induction technique in different time of hospitalization. We finally found a positive result of both examinations in the third hospitalization. The diagnosis of TB was further reinforced with clear clinical improvement after 1 month of anti TB treatment
Learning Points/Discussion : It takes serious effort, repetitive and not giving up on the difficulty in obtaining a specimen in children with suspicion of TB, especially in children with comorbidity like HIV and malnutrition
Keywords: Tuberculosis in children Positive acid-fast bacillus Positive GeneXpert TB
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