Fatal congenital tuberculosis due to a Beijing strain in a premature neonate

Abstract

Congenital tuberculosis (TB) remains a rare disease but is fatal if untreated. Early detection is difficult because of the non-specific nature of the symptoms in TB during pregnancy and infancy. This report summarizes a case of congenital TB in a very premature infant, born at 25 weeks gestation. Miliary TB was diagnosed in the mother when the neonate was 20 days old. Antituberculous therapy allowed a rapid improvement in the mother. The infant died at 27 days old. A Beijing genotype strain of Mycobacterium tuberculosis was isolated both in the mother, from pulmonary and urine specimens, and in the infant, from peritoneal fluid.

A Perspective of the Diagnosis and Management of Congenital Tuberculosis

“…It is lower in developed countries, making it an unknown disease and difficult to evoke [10]. The mortality rate is very important and high, nearly 50%, which is often due to delayed diagnosis followed to delayed treatment [3], and 22% among patients receiving chemotherapy [7]. Furthermore, newborn infants who suffer from congenital TB after 4 weeks of age have a 77% existence rate compared with 44% survival in those who suffer before 4 weeks [25].…”

“…In the second or third week after childbirth, the symptoms usually emerge and precocious diagnosis is essential. However, the clinical presentation of TB during pregnancy and infancy is often nonspecific, making recognition difficult [3]. Only 300 cases were reported in the scientific literature till 1989; subsequently, 58 cases in 1994 and, from 2001 to December 2005, 18 more cases have been mentioned [4].…”

Congenital tuberculosis complicated by interstitial pulmonary emphysema

“…The probable reason for the rarity may be under-reporting of the disease and lack of good diagnostic tools. [23]…”

“…Even in areas endemic for the disease, congenital tuberculosis has rarely been reported. [123] We report a 6-week-old female infant who presented with difficulty in breathing since birth. The diagnosis was made based on X-ray chest, which showed milliary mottling of lungs and demonstration of mycobacterium tuberculosis in endometrial biopsy of mother.…”

A Case of Congenital Tuberculosis in a Tertiary Care Hospital

“…Early detection is difficult because of the nonspecific nature of symptoms during pregnancy and infancy. 3 Despite the high incidence of tuberculosis in women of reproductive age, the incidence is estimated at only 2% because of subclinical forms of the disease during pregnancy, and the lack of adequate prenatal care in countries with a low development rate. Some authors believe that undernotification of cases could explain this low incidence.…”