A Perspective of the Diagnosis and Management of Congenital Tuberculosis

Abstract

Tuberculosis continues to be a prevalent disease in the world and a global public health issue in many countries. The disease is more complicated in pregnant women because it imperils unborn offspring and results in congenital tuberculosis later if undiagnosed and untreated. Congenital tuberculosis is rare entity and an uncommon disease along with a high mortality rate. Congenital tuberculosis, a severe clinical type of tuberculosis caused by Mycobacterium tuberculosis, is a serious and fatal disease if left untreated. Our study emphasizes that it is necessary and mandatory to consider congenital tuberculosis in the differential diagnosis of neonatal or pulmonary infections in infants, essentially in countries where the incidence of tuberculosis is high burden. Mother to neonatal transmission of disease is well known via transplacental transmission through the umbilical vein to the fetus, through the ingestion of infected amniotic fluid. Early detection is challenging, because of the nonspecific nature of the signs and symptoms in tuberculosis during pregnancy and infancy. The degree of clinical suspicion is the essential component of diagnosis. Furthermore, it generally has a difficult treatment and it should not be delayed while waiting for diagnostic test results. Prompt identification and proper treatment regimens for congenital tuberculosis strongly relate with enhanced outcomes.

Tuberculosis congénita pre-extensivamente resistente a drogas: reporte de caso

“…La TB congénita es una forma de presentación rara de la infección tuberculosa, cuya transmisión se da intraútero. Usualmente el diagnóstico de la madre se hace posparto, debido a que suelen ser asintomáticas durante el embarazo (2) , siendo la activación de la enfermedad durante la gestación un factor de riesgo importante para la trasmisión vertical (8) .…”

“…Respecto a las imágenes, las radiografías de tórax de los infantes con TB congénita varían desde normales hasta hallazgos patológicos como patrón miliar, consolidación, cavitación, patrones intersticiales, nódulos múltiples, y linfadenopatías hiliares y mediastinales, entre los más frecuentes (1,2,8) . La tomografía de tórax es más sensible para detectar algunos de estos signos, como en el presente reporte, donde se halló en un inicio, un infiltrado retrocardiaco izquierdo y luego se evidenció la presencia de micronódulos en ambas bases pulmonares con discreto patrón reticular.…”

Management of newborns at risk of neonatal and perinatal tuberculosis

“…Maternal TB has been associated with an increased risk of spontaneous abortion, perinatal mortality, small size for Newborns with TB show high mortality rate (up to 60%) and high risk of disease progression (40%) [2,3]. Given these assumptions, early treatment is mandatory.…”

Signature of circular RNAs in peripheral blood mononuclear cells from patients with active tuberculosis

“…1 Early identification and proper therapy can obviously improve active TB patients' outcome. 2 Great advances and many efforts have been made to treat and understand basal mechanisms of TB infection in recent years. However, remission rates remain suboptimal and TB diagnosis is still challenging due to the limitations in the specificity and sensitivity of the current diagnostic tests.…”