Pulmonary tuberculosis

We present a case of previously undiagnosed and unsuspected pulmonary tuberculosis (TB) identified on post mortem histology. The presentation of TB in the mortuary is reviewed and we present the key learning points regarding dealing with this infection in the post mortem patient.Trainees should appreciate that although a rare occurrence, pulmonary TB may go undiagnosed until after death, and given its ability to survive in the post mortem patient, the use of personal protective equipment is paramount.     

Tuberculosis treatment in children: The changing landscape

Traditionally children have been treated for tuberculosis (TB) based on data extrapolated from adults. However, we know that children present unique challenges that deserve special focus. New data on optimal drug selection and dosing are emerging with the inclusion of children in clinical trials and ongoing research on age-related pharmacokinetics and pharmacodynamics. We discuss the changing treatment landscape for drug-susceptible and drug-resistant paediatric tuberculosis in both the most common (intrathoracic) and most severe (central nervous system) forms of disease, and address the current knowledge gaps for improving patient outcomes.     

Preventing tuberculosis in children: A global health emergency

It is estimated that 20 million children are exposed to tuberculosis (TB) each year, making TB a global paediatric health emergency. TB preventative efforts have long been overlooked. With the view of achieving “TB elimination” in “our lifetime”, this paper explores challenges and potential solutions in the TB prevention cascade, including identifying children who have been exposed to TB; detecting TB infection in these children; identifying those at highest risk of progressing to disease; implementing treatment of TB infection; and mobilizing multiple stakeholders support to successfully prevent TB.     

Acromioclavicular joint tuberculosis: A report of two cases

Acromioclavicular joint tuberculosis is an extremely rare presentation with only 16 cases reported so far and has a relatively high propensity to be misdiagnosed. India being a tuberculosis endemic region accounts for almost 27% of cases worldwide (global index of 2018 was 10 million). With a higher index of suspicion an earlier diagnosis can be made. We report two patients of AC joint tuberculosis, treated with multidrug chemotherapy resulting in a good functional outcome.