Universität zu Köln

van de Loo, Karoline, Balzer, Stefan, MacKenzie, Colin R., Boemers, Thomas M., Ortmann, Monika, Schaper, Joerg, Borkhardt, Arndt, Laws, Hans-Juergen and Kuhlen, Michaela (2018). Lymphnode tuberculosis in a 4-year-old boy with relapsed ganglioneuroblastoma: a case report. BMC Infect. Dis., 18. LONDON: BMC. ISSN 1471-2334

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Abstract

Background: Mycobacterium tuberculosis (M. tuberculosis) disease is a generally well-known problem among immunocompromised adults and children. In pediatric oncology, only few cases of M. tuberculosis disease are reported so far. Case presentation: We report a case of concomitant lymphnode tuberculosis in a 4-year-old German boy with relapsed ganglioneuroblastoma. 18 months after the initial diagnosis, relapse with new paravertebral lesions and new lesions in the left lower lobe of the lung and in the perihilar lymphnodes suspicious of metastases of the ganglioneuroblastoma were detected. While relapse in the tumor was confirmed, unexpectedly, pathologic examination revealed morphological diagnosis of lymphnode tuberculosis. The boy was of German background without previous history of tuberculosis exposure. Both, antituberculostatic and relapse treatment were immediately initiated. Three months on, MRI revealed regressive findings in the lung and lymphnodes and partial response in the tumor. The patient underwent second MiBG therapy and haploidentical stem cell transplantation. Conclusion: The diagnosis of lymphnode tuberculosis in a 4-year-old German boy with relapsed ganglioneuroblastoma was only made by chance, but most likely saved his life. Pediatric oncologist should be aware of tuberculosis as the incidence might increase over time and the timely diagnosis of a potentially preventable M. tuberculosis disease is irreplaceable. Further studies are needed to explore the incidence of M. tuberculosis infections and the value of IGRA, testing for latent tuberculosis infection prior to chemotherapy in children with underlying malignancies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van de Loo, Karoline UNSPECIFIED UNSPECIFIED UNSPECIFIED Balzer, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED MacKenzie, Colin R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boemers, Thomas M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ortmann, Monika UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaper, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Borkhardt, Arndt UNSPECIFIED UNSPECIFIED UNSPECIFIED Laws, Hans-Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhlen, Michaela UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-193020
DOI:	10.1186/s12879-018-3016-x
Journal or Publication Title:	BMC Infect. Dis.
Volume:	18
Date:	2018
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2334
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MARROW-TRANSPLANTATION; PULMONARY TUBERCULOSIS; CHILD Multiple languages Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19302