Extensively drug-resistant tuberculosis of the lumbar spine
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Extensively drug-resistant tuberculosis (XDR-TB) is caused by the strain of Mycobacterium tuberculosis resistant to isoniazid and rifampicin (multidrug-resistant [MDR]-TB), with resistance to a fluoroquinolone and to at least one injectable second-line drug (amikacin, capreomycin [Cm], or kanamycin). According to the WHO 2015 report, XDR-TB has been reported in 105 countries and approximately 9.7% of MDR-TB cases are caused by XDR strains globally. Treatment of XDR-TB is prolonged chemotherapy with second-line antitubercular drugs, which have a lower potency to adverse effect ratio. Children are a susceptible population for TB with unique management difficulties due to the paucibacillary nature of the infection as well as due to the scarcity of child-friendly drug formulations and lack of evidence-based dosing recommendation for some drugs. We present a case of XDR-TB of the lumbar spine in a 6-year-old child, managed with drug sensitivity-based second-line antituberculous drug regimen.

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