Identification and Treatment of Tuberculosis in Pediatric Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: Case Series and Review of the Literature

Xiaodong Wang1,2 ,* Uet Yu2 ,* Xiaonan Li,3 Chunjing Wang,2 Qian Zhang,2 Chunlan Yang,2 Xiaoling Zhang,2 Yu Zhang,2 Ying Wang,2 Yuejie Zheng,3 Jikui Deng,4 Weiguo Yang,5 Guosheng Liu,1 Guofang Deng,6 Sixi Liu,2 Feiqiu Wen1,2 1Department of Pediatrics, First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China; 2Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China; 3Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China; 4Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China; 5Pediatric Intensive Care Unit, Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China; 6Guangdong Key Laboratory for Emerging Infectious Diseases & Shenzhen Key Laboratory of Infection and Immunity, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sixi Liu; Feiqiu Wen Email tiger647@126.com; fwen62@163.comBackground: Tuberculosis is a rare but life-threatening complication in patients who received hematopoietic stem cell transplantation. Early identification and intervention are essential to prevent severe complications.Case Presentation: We report two pediatric patients who developed tuberculosis after receiving hematopoietic stem cell transplantation for thalassemia major among 330 recipients between January 2012 and August 2019. Patient A presented with pulmonary tuberculosis and patient B presented with lymph node tuberculosis mimicking post-transplantation lymphoproliferative disorder associated with Epstein–Barr virus reactivation. Patient B’s condition was deteriorated, and shortly after the initiation of anti-tuberculosis therapy