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P272 The importance of directly observed therapy in perinatal tuberculosis
  1. Aysun Yahşi1,
  2. Tuğba Erat1,
  3. Halil Özdemir1,
  4. Tuğçe Tural Kara1,
  5. Ekin Zeynep Altun2,
  6. Bilge Aldemir Kocabaş3,
  7. Erdal Ince1,
  8. Ergin Çiftçi1
  1. 1Ankara Univesity Medical School Department of Pediatric Infectious Diseases, Ankara University Medical School, Ankara, Turkey
  2. 2Ankara Univesity Medical School Department of Pediatrics, Ankara University Medical School, Ankara, Turkey
  3. 3Department of Pediatric Infectious Diseases, Ministry of Health, Antalya Training and Research Hospital, Antalya, Turkey

Abstract

9.5 month-old boy presented with a one-month history of cough and lymphadenopathy. The mother was diagnosed with pulmonary tuberculosis when the baby was 1,5 months old. Thus, the breastfeeding was stopped and isoniazid prophylactic therapy was recommended to baby. However, the treatment was only applied between 6–9 months old by the family. He was evaluated for pneumonia at first and nonspecific antibiotic therapies were started. After ten-day treatment, the symptoms didn’t get better. He was again evaluated and three serial samples of gastric aspirates that sent for ARB and Tbc PCRes were positive. Chest CT revealed that concerning the whole middle and lower lobes in the right lung at the widespread consolidation area, necrotic areas where the largest reached over 23 × 13 mm was monitored. He was administered a four-drug anti-tuberculous treatment of INH (11.5 mg/kg), rifampicin (15 mg/kg), pyrazinamide (25 mg/kg), etambuthol (18.75 mg/kg). At the first month of treatment all acid fast stains and PCR were negative. Even though ChestCT were the same, findings showed remarkable improvement After 2 months the child was discharged to his home with two-drug- maintence therapy. As well as early diagnosis and treatment, directly observed therapy is crucial in tuberculosis.

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