Usage of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT/GeneXpert) test as diagnostic modality for pediatric tuberculosis; case series from Mangalore, South India

Abstract

Background: Diagnosis of Tuberculosis in children is challenging. Hereby we report a case series of 4 patients where Cartridge Based Nucleic Acid Amplification Test (CB NAAT) helped us in early diagnosis.

Case characteristics: Case 1 was a 14-year old girl who was on anti-tuberculous therapy (ATT) for 2 months without any improvement; sputum CBNAAT detected multi-drug resistant tuberculosis (MDR-TB). Case 2 was a 9-year old boy with history and examination findings suggestive of meningitis; CB-NAAT of the cerebrospinal fluid (CSF) was positive. Case 3 was a 1-year old child having fever, cough of 1 month duration with Mantoux positive. CB-NAAT of gastric lavage was positive. Case 4 was a 3- month old child who presented with severe respiratory distress of 11 days duration. Chest x-ray showed miliary mottling; CB-NAAT of gastric lavage was positive.

Conclusion: CB-NAAT testing was very useful in making an early and definitive diagnosis of tuberculosis, including MDR-TB.

Keywords: CB-NAAT; GeneXpert; Pediatric; Tuberculosis.

Fig. 1

Case 1. CT chest showing the Consolidation with breakdown cavitations of apico-posterior lobe in right lung, areas of consolidation with cavitation interspersed left lung, multiple centric lobar nodules with tree in bud appearance, multiple pre & para tracheal lymph nodes.

Fig. 2

Case 2. Chest x-ray showing bilateral miliary mottling.