Tuberculosis Treatment in Young Children: Risks and Concerns

Pediatric pulmonary tuberculosis infection

Hello, Doctor! My father was diagnosed with open pulmonary tuberculosis in June of this year, and he has been cured for a month now.
He has been taking his medication regularly and attending follow-up appointments.
The doctor mentioned that his infectiousness has significantly decreased to the point of being non-infectious, and his sputum test results are at 0.
Our whole family went to the Tuberculosis Prevention Association for chest X-rays to check for any transmission.
On July 12, I took my daughter (who is currently 1 year and 2 months old) to receive a subcutaneous injection.
Today, July 14, we returned for the report, and the doctor said the X-ray looked normal! However, the subcutaneous area is red and swollen, about 2 centimeters in size, so it has been confirmed that she will need to take anti-tuberculosis medication for 270 days.
After one month of medication, we will return for a check on her liver function tests.
I looked up the process, and it seems to be correct.
I would like to ask the doctor if taking tuberculosis medication for 270 days will have serious side effects for a child over 1 year old? I have heard from friends that family members who had tuberculosis may have health issues later on, and I also read online that, besides liver function, it could affect vision.
Is this true, Doctor? Thank you! I am a very worried mother seeking advice.

Megan, 30~39 year old female. Ask Date: 2021/07/14

Dr. Jian Shuntian reply Pulmonology

A child over 1 year old has a 2 cm positive tuberculin skin test, which is considered strongly positive, indicating a significant risk of developing tuberculosis.
It is recommended that the child undergo 270 days of preventive treatment with isoniazid (INH).
The likelihood of side effects from this treatment in young children is very low; however, monthly follow-up visits are necessary for physician evaluation.
Thank you.

Reply Date: 2021/07/14

More Info

When it comes to treating tuberculosis (TB) in young children, particularly in the case of your one-year-old daughter who has been prescribed a 270-day course of medication, it is understandable to have concerns about potential side effects and the overall impact on her health.
Firstly, it is important to recognize that tuberculosis, especially in children, can be a serious condition. The fact that your daughter has tested positive for TB and is being treated is a proactive measure to prevent the disease from progressing. The treatment regimen typically involves the use of antibiotics such as Isoniazid (INH) and Rifampin, which are effective in combating the bacteria that cause TB.

Regarding the potential side effects of these medications, it is true that all medications can have side effects, but the risk of severe side effects in young children is generally low, especially when the treatment is closely monitored by healthcare professionals. Common side effects of TB medications can include nausea, fatigue, and liver function abnormalities. For this reason, regular follow-up appointments to monitor liver function and overall health are crucial. Your healthcare provider will likely perform blood tests to assess liver enzymes after the first month of treatment to ensure that the medications are not causing any harm.

Concerns about long-term health effects, such as those related to liver function or vision, are valid but should be put into context. While it is true that some TB medications can affect liver function, the benefits of treating latent TB far outweigh the risks, especially in a child who has been exposed to the disease. Vision problems are not commonly associated with standard TB treatment; however, if there are any specific concerns about vision or other health issues, it is essential to discuss these with your child's doctor.

It is also important to note that the risk of developing active TB disease from latent TB infection is significant, particularly in young children. Therefore, the decision to treat your daughter with a 270-day course of medication is a preventive measure to reduce the risk of future complications.
As for the concerns raised by friends or information found online, it is crucial to rely on the guidance of healthcare professionals who are familiar with your daughter's specific case. Each child's situation is unique, and the healthcare team will tailor the treatment plan based on her needs and health status.

In summary, while there are potential side effects associated with TB medications, the risk of severe complications from untreated latent TB is much higher. Regular monitoring and communication with your healthcare provider will help ensure that any side effects are managed effectively. It is understandable to feel anxious about your child's health, but with appropriate medical care and follow-up, the treatment can be both safe and effective in preventing the progression of tuberculosis. Always feel free to reach out to your child's doctor with any questions or concerns you may have during the treatment process.

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