Congenital miliary tuberculosis in an 18-day-old boy

Abstract

Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day. Chest X-ray showed diffuse fine bilateral infiltration. Clinically, pneumonia or sepsis was suspected. Respiratory symptoms and chest X-ray findings worsened despite empirical antibiotic therapy. The lungs showed miliary infiltration suggestive of TB. Gastric aspirates were positive for M. tuberculosis. Respiratory distress and fever were gradually improved after anti-TB medication. Congenital TB is difficult to detect because of minimal or no symptoms during pregnancy and nonspecific symptoms in neonates. Hence, clinicians should suspect the possibility of TB infection even if neonates have non-specific symptoms. Early diagnosis and meticulous treatment are required for the survival of neonates with TB.

Is there a connection between gestational diabetes mellitus, human immunodeficiency virus infection, and tuberculosis?

“…11,12,15 There is also a 3.4-fold increased risk of death 16 and congenital TB, many in infants of women who developed active TB after in vitro fertilization. 17–20…”

Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia: a case report

“…Fever, hepatosplenomegaly, and respiratory distress are the most common manifestations of perinatal TB, which occur frequently in the second to fourth week of life. Septic shock may develop in severe cases [ 2 - 4 , 6 ]. As discovered in this case, clinical manifestations appeared in the fourth week of life.…”

“…Perinatal TB should be suspected and investigated in the following conditions: (i) neonates who failed to respond to conventional management of pneumonia, particularly in those from endemic areas, (ii) if the mother or family member is diagnosed as having TB, (iii) in the presence of unexplained fever and hepatomegaly [ 2 , 9 ]. In this case, the patient experienced symptoms similar to sepsis and neonatal pneumonia.…”

Latent tuberculosis-induced hydrops fetalis with congenital tuberculosis

“…Mycobacterium tuberculosis droplet inhalation generally causes TB [5]. The transmission pathway of tubercle bacilli from the mother to the fetus is via inhalation of amniotic fluid during labor or hematogenous spread through the placenta via mechanisms that have not yet been clearly elucidated [6,7]. When the mother has TB, the risk of neonatal morbidity and mortality, such as acute fetal distress, prematurity, small-for-gestation age, low birth weight, and perinatal death, is increased [8].…”