Abstract:Congenital tuberculosis is an unusual and severe clinical pattern of tuberculosis presentation of Mycobacterium tuberculosis infection. Furthermore, it usually has a difficult treatment. We report a two-month-old male infant who presented with fever, dyspnea and a diffuse micronodular pattern at x-ray; mother with severe tuberculosis. Treatment with the triple drug regimen was initiated, but the child developed jaundice and an increase in liver enzymes on various occasions during treatment. A regimen specifica… Show more
“…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%
“…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 .…”
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.
“…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%
“…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 .…”
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.
“…The incidence of congenital tuberculosis in women of reproductive age group in countries where the disease is endemic is estimated at 2%,1 with approximately 340 cases described in the literature 2. Diagnosis of congenital tuberculosis is difficult due to non-specific symptoms, and a high index of suspicion is required for early diagnosis in infants in order to reduce mortality.…”
Genital tuberculosis is a major cause of infertility in countries where tuberculosis is endemic. With recent advances in assisted reproductive technology, women with tuberculous endometritis may become pregnant and ultimately have children with congenital tuberculosis. In vitro fertilisation represents a useful treatment for infertility. Congenital tuberculosis is a rare and severe, rapidly progressive, disease. Making an early diagnosis of congenital tuberculosis is difficult, because it can mimic many neonatal illnesses. To the best of our knowledge, we report the first cases of premature twins with congenital tuberculosis following in vitro fertilisation. After the diagnosis of genital tuberculosis in the mother, the twins were screened and diagnosed for tuberculosis. The twins dramatically improved after anti-tuberculosis therapy. We also wish to draw attention to the importance of searching for genital tuberculosis as the possible cause of congenital infection, even if the mother is asymptomatic.
“…Clinical manifestations of congenital and neonatal TB are non-specific, they usually present like neonatal sepsis and diagnosis is often delayed [15–18]. Low birth weight and prematurity are common features of HIV and TB infected neonates born to HIV-infected mothers with TB [19].…”
Section: Casementioning
confidence: 99%
“…These criteria increase diagnostic sensitivity, but the diagnosis remains difficult since confirmation of the primary complex or detection of granulomas in the liver has to be carried out by biopsy, which is not always available [20]. In our case a liver biopsy was never performed [15]. …”
AbstractChildren bear a substantial part of the tuberculosis
(TB) epidemic worldwide, and it is estimated that
there were ≅ 500.000 childhood TB cases globally in 2010,
although accurate data are problematic to obtain given
the many difficulties associated with TB diagnosis in children
and the weaknesses of surveillance systems in countries
where TB is endemic. The World Health Organization
is working hard in order to reduce the TB prevalence rates
and deaths by half by 2015. In this challenge, general
practitioners and pediatricians play a key role in detecting
early cases of suspected TB and sending them to experts
in infectious diseases. This will reduce delayed diagnosis
and the spread of disease, which is especially important
now that the prevalence of multidrug resistant TB is
increasing. For this reason, the purpose of this report was
to delineate the characteristic clinical features of the most
common forms of pediatric TB and to suggest a rational
and practical approach to the disease underlining the role
of patients and parents personal and clinical history.
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