Unusual Case at JJ Hospital Raises New Concerns
Doctors at Mumbai’s state-run JJ Hospital are no strangers to complex cases. Yet, a recent diagnosis has left them astonished—a three-month-old boy has become the hospital’s youngest patient with drug-resistant tuberculosis (TB), despite showing no visible symptoms. The condition typically requires 18 months of treatment, although newer 6-month regimens are now available.
No Symptoms, But Lungs Reveal the Truth
The infant appeared perfectly healthy—he was breathing normally, feeding well, and steadily gaining weight. However, when a doctor treating his mother for suspected TB requested a chest X-ray as part of household contact screening, the results were shocking.
“The child’s lungs showed increased opacity, clearly indicating TB,” said Dr. Sushant Mane, Associate Professor and Nodal Officer for Paediatric TB at JJ’s National Center of Excellence for TB. “Patients with such extensive lung involvement usually struggle to breathe, eat, and lose weight. This child had none of those issues—not even a persistent cough, which is a hallmark symptom of TB.”
Rapid Referral and Diagnosis of Drug-Resistant TB
As reported by TOI, the family, living in the city’s western suburbs, was immediately referred to JJ Hospital’s paediatric TB ward in Byculla. Doctors performed a gastric lavage, which confirmed that the infant had a drug-resistant form of TB. Interestingly, the mother’s TB test results have so far been inconclusive, although her symptoms—especially persistent coughing—led doctors to begin treatment.
Administering Advanced TB Drugs to an Infant
The child may also be among the youngest in India to receive newer anti-TB medications such as bedaquiline. “As per standard paediatric protocol, we had the tablets pulverised at Byculla Pharmacy. The powdered dose is packed into ‘pudis,’ which the parents mix with water or breast milk,” Dr. Mane explained.
Though the World Health Organization has established protocols and dosages for neonates, most countries—including India—continue to use non-dispersible versions of these advanced drugs.
Ongoing Monitoring Shows Positive Response
Two weeks after the diagnosis, the mother brought the baby back to JJ Hospital with concerns about coughing. However, doctors found no serious cause for concern. “He is tolerating the medication well and has continued to gain weight,” said Dr. Mane. After three months of treatment, doctors will retest to assess whether the drugs are effectively eliminating the infection.
Paediatric TB in Mumbai: An Alarming Trend
Paediatric TB began surfacing as a public health challenge in Mumbai about a decade ago. The city reports over 60,000 new TB cases annually, of which around 5,000 are drug-resistant. According to BMC Executive Health Officer Dr. Daksha Shah, children account for 8–10% of these cases.
Dr. Vikas Oswal, who oversees the TB programme at BMC-run Shatabdi Hospital, noted that improved diagnostic tools have made it easier to detect TB in young children. “What’s worrying is the declining age of patients. A few years ago, we were shocked to see TB in two- or three-year-olds. Now, we’re seeing more cases in infants under one year old.”
A Wake-Up Call for Early Screening and Intervention
This rare and silent case of TB in a three-month-old underscores the urgent need for vigilant screening of household contacts—especially in high-burden cities like Mumbai. With the age of paediatric TB patients steadily dropping, early detection and timely intervention remain critical in saving young lives.