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Latent TB – child contact — RACP Paediatrics MCQ

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ModerateIDLatent TB – child contactRACP Paediatrics

A 3-year-old Aboriginal child from a remote community is a close contact of a confirmed TB case (the child's parent). The child is well with no symptoms. Mantoux test is 12 mm. Chest X-ray is normal. What is the most appropriate management?

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Correct answer: E — Isoniazid monotherapy for 6 months

A well child with positive Mantoux (≥10 mm in high-risk groups) and normal CXR after known TB contact has latent TB infection (LTBI). Isoniazid monotherapy for 6 months (or shorter rifampicin-based regimens) is the standard treatment for LTBI in children to prevent progression to active disease. Pyridoxine supplementation is recommended to prevent isoniazid-induced neuropathy.

Reference: Australian Therapeutic Guidelines – 2024 – Antibiotic; RCH Melbourne – 2023 – TB CPG