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Latent tuberculosis infection — RACP Paediatrics MCQ

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HardInfectious diseases and immunisationLatent tuberculosis infectionRACP Paediatrics

A 4-year-old household contact of an adult with pulmonary tuberculosis has a positive IGRA. He is asymptomatic, examination is normal and chest radiograph is normal. What is the most appropriate management?

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Correct answer: C — Treat latent tuberculosis infection after excluding active disease

A young child with positive IGRA after household exposure and no active disease should receive latent TB treatment to prevent progression. A normal chest radiograph excludes pulmonary disease but does not remove the risk of future activation. The pearl is that children have higher progression risk than adults, so contact tracing pathways should be followed closely.

Reference: Therapeutic Guidelines (eTG): Antibiotic; Australian tuberculosis control guidance