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Does my son have tuberculosis?

Q: My 9 years old son was admitted to hospital because of headache and vomiting. His MRI report was normal but cerebrospinal fluid (CSF) shown mild meningitis. On the second day in the hospital there was no symptom and he was perfectly normal. Although due to the mild meningitis, IV antibiotics have been administered. Also, few other tests were performed including Mantoux test for tuberculosis; result was positive around 30 mm. However x-ray, blood report test were normal. Second CSF was done on the 8th day where the cell count has gone down, and there was no bacterial growth observed. TB-PCR test was also done, which was negative. So based on the Mantoux test, should we start treatment for TB as there is no other positive test, which has shown TB? Please advise.

A:It appears from your description that the meningitis has been cured for your child. In an otherwise healthy child, where all other investigations are normal and an incidental finding of positive Mantoux test is there, you could just observe the child for few weeks for any symptoms, which could suggest tuberculosis. It may not be absolutely essential to start this 9-year-old child on antitubercular treatment.

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