Artigos do Autor

A clinical case Pedro, an eight-month old child, weighing nine kilos arrived to the emergency room with a fever and drowsiness. These symptoms were said to have been displayed the last two weeks. Suddenly Pedro presented with meningism and seizures. After an examination and lab test were performed, TB meningitis was confirmed. Pedro underwent surgery for ventricular peritoneal derivation. He survived but remained disabled. BACKGROUND: Six months before the onset of the symptoms, the mother was diagnosed with pulmonary TB. Despite the fact that contact tracing is part of the policy of the TB program, nobody asked the mother about household contacts, in particular those under five years of age. Two months later, a nurse went to the patients' home and found that there was a 4 months old child. Even though the nurse visited the home, the child was eventually only examined two months later, and Isoniazid Preventive Therapy (IPT) was therefore started late. During the first follow up, the child had received one month of IPT. At the request of the family, the peadiatrician decided to stop the IPT based on the fact that the mother was smear negative at that moment, and based on the fact that the child was well and previously vaccinated with BCG. The tragedy started one month later. EVALUATION: This case study summarizes a sequence of poor decision making: contact tracing was not implemented as it should; children are often not being considered a priority; a full course of IPT was interrupted. Suffering and disability could have been avoided.