Perinatal tuberculosis: a diagnostic challenge

Souza, Edna Lúcia; Moreira, Lícia Maria Oliveira; Silva, Márcio Fernando

doi:10.1590/s1413-86702006000300012

Cited by 6 publications

(11 citation statements)

References 6 publications

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“…In the review of 75 congenital TB cases (see Methods) we found that information on maternal TB was available in 65; 43 had chest radiograph results. Of these 43, 14 (33%) had a normal chest radiograph with confirmed extrapulmonary TB, 12 (28%) had pleural effusions of whom six also had other pulmonary infiltrates (only one culture‐positive), eight (19%) had miliary TB and 10 (23%) had only pulmonary TB, most of which was culture‐negative TB 6–43 . Other types of extrapulmonary TB identified in these mothers were endometrial TB confirmed in 22 of 25 tested, central nervous system TB in six, osteoarticular and abdominal TB in three each.…”

Section: Tuberculosis In the Very Youngmentioning

confidence: 98%

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Tuberculosis at extremes of age

Schaaf¹,

Collins²,

Bekker³

et al. 2010

Respirology

127

112

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Although tuberculosis (TB) has its highest burden among young adults, especially since the advent of HIV infection, two other groups with low immunity, the very young (<1 year) with immature immunity and the elderly (>65 years) with waning immunity, are vulnerable groups not to be forgotten. This review describes the epidemiology,clinical aspects,public health aspects and outcome of TB in patients at the extremes of age. The epidemiology differs therein that TB in infants occurs in developing countries with high incidences of TB and HIV, while TB in the elderly occurs in developed countries with ageing populations. The clinical presentation may be non-specific, history of contact with TB is often not known and TB is often not considered at these age extremes, and when the diagnosis is considered, disease progression may already be advanced. Anti-TB treatment regimens are the same as in other age groups, but drug dosages may need adjustment according to weight, renal function, liver function and other potentially complicating factors. Adverse events are more difficult to observe and both the young and the elderly are reliant on others for adherence to treatment. Mortality at both age extremes is higher than in the general TB population. For all the above reasons, public health measures to: prevent transmission of infection; identify those infected and providing preventive therapy; high index of suspicion in order to make an early diagnosis; and timely initiation of treatment are important in both the very young and the elderly.

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Section: Tuberculosis In the Very Youngmentioning

confidence: 98%

“…The clinical presentation of congenital TB in the review of 75 cases is summarized in Table 1 6–43 . Although postnatal TB may clinically be indistinguishable from congenital TB, the presence of a hepatic granuloma is fairly pathognomic of congenital TB 9 .…”

Section: Tuberculosis In the Very Youngmentioning

confidence: 99%

Tuberculosis at extremes of age

Schaaf¹,

Collins²,

Bekker³

et al. 2010

Respirology

127

112

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“…Over the years, demonstration of AFB using GA has been the most convenient and sensitive technique. 2,6,[8][9][10][11] Various modalities for diagnosing perinatal/congenital tuberculosis are shown in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Perinatal tuberculosis: four cases and use of broncho‐alveolar lavage

Parakh

Saxena

Thapa

et al. 2011

Annals of Tropical Paediatrics

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Despite the high prevalence of tuberculosis in adults and children, congenital and perinatal forms of tuberculosis are rare. Four patients with perinatal tuberculosis are described. Diagnosis was made by demonstration of acid-fast bacilli (AFB) on broncho-alveolar lavage (BAL) specimens (two cases), gastric aspirate smear (one case) and lymph node fine-needle aspirate (one case). All of the above specimens were subsequently positive on culture. Two infants died of progressive pulmonary failure, and one of the mothers died, despite the institution of anti-tuberculous therapy. BAL specimen examination for AFB is useful in the diagnosis of perinatal tuberculosis, especially in infants with smear-negative gastric aspirate.

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“…15 Although there are a number of reports, congenital TB is rare but it might be underdiagnosed, especially in developing countries where infants may die before a diagnosis is made. [15][16][17][18] Definitive diagnosis of perinatal TB requires demonstration of mycobacteria in body fluids either by direct microscopy or by culture. Demonstration of tubercle bacilli in direct smear from gastric aspirate or CSF is often difficult because of the paucity of organisms.…”

Section: Discussionmentioning

confidence: 99%

Perinatal tuberculosis: two unusual cases

Basu

Kumar

Das

2011

Annals of Tropical Paediatrics

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Two immunocompromised infants with perinatal tuberculosis are reported. Both presented with bilateral miliary mottling of the lungs. The first was a 4-month-old boy with a history of prolonged administration of prednisolone. He had tuberculous meningitis. Diagnosis was confirmed by PCR in serum and CSF. His mother had tuberculous endometritis. The second was a 1-month-old boy with perinatal HIV infection. Diagnosis was made by PCR in serum. Both parents were HIV-infected and had open pulmonary tuberculosis.

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Perinatal tuberculosis: a diagnostic challenge

Cited by 6 publications

References 6 publications

Tuberculosis at extremes of age

Tuberculosis at extremes of age

Perinatal tuberculosis: four cases and use of broncho‐alveolar lavage

Perinatal tuberculosis: two unusual cases

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