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- Title
Identification and Treatment of Tuberculosis in Pediatric Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: Case Series and Review of the Literature.
- Authors
Wang, Xiaodong; Yu, Uet; Li, Xiaonan; Wang, Chunjing; Zhang, Qian; Yang, Chunlan; Zhang, Xiaoling; Zhang, Yu; Wang, Ying; Zheng, Yuejie; Deng, Jikui; Yang, Weiguo; Liu, Guosheng; Deng, Guofang; Liu, Sixi; Wen, Feiqiu
- Abstract
Background: Tuberculosis is a rare but life-threatening complication in patients who received hematopoietic stem cell transplantation. Early identification and intervention are essential to prevent severe complications. Case Presentation: We report two pediatric patients who developed tuberculosis after receiving hematopoietic stem cell transplantation for thalassemia major among 330 recipients between January 2012 and August 2019. Patient A presented with pulmonary tuberculosis and patient B presented with lymph node tuberculosis mimicking post-transplantation lymphoproliferative disorder associated with Epstein–Barr virus reactivation. Patient B's condition was deteriorated, and shortly after the initiation of anti-tuberculosis therapy, the patient was found to have disseminated pulmonary tuberculosis. Patient B was also found to have tuberculous granulomas, an uncommon manifestation of tuberculosis causing severe airway obstruction. Both patients developed critical respiratory failure and required mechanical ventilation; however, they recovered with almost full resolution of pulmonary lesions after multiple treatment adjustments. Conclusion: Tuberculosis must be carefully evaluated in all pediatric patients that receive hematopoietic stem cell transplantation, regardless of the identification of other pathogens. Prophylactic tuberculosis therapy should be considered for high-risk pediatric hematopoietic stem cell transplantation recipients from tuberculosis-endemic regions.
- Subjects
HEMATOPOIETIC stem cell transplantation; TUBERCULOSIS; EOSINOPHILIC granuloma; SPINAL tuberculosis; PEDIATRIC therapy; LITERATURE reviews; VIRUS reactivation; TUBERCULOSIS patients
- Publication
Infection & Drug Resistance, 2020, Vol 13, p2641
- ISSN
1178-6973
- Publication type
Article
- DOI
10.2147/IDR.S256298