Congenital tuberculosis detected by T-SPOT.TB assay in a male infant after in vitro fertilization and followed up with radiography

Abstract

Congenital tuberculosis (TB) is a rare disease with a high mortality rate, and is difficult to diagnose. Here we present a case of congenital TB detected by the T-SPOT.TB assay in a male infant after in vitro fertilization. He ultimately survived after anti-TB therapy despite a delayed diagnosis, and underwent radiological follow-up. The delay in diagnosis of congenital TB resulted in a severe lung lesion, as evidenced by prolonged oxygen dependence, predisposing to recurrent pneumonia. Radiological follow-up revealed uniform rim calcification of multiple enlarged lymph nodes in the mediastinum, and long-term consolidation in the bilateral lung, with slow radiographic regression of the lung lesion. To the best of our knowledge, this is the first report on using the T-SPOT.TB assay in the detection of congenital TB, and no case of congenital TB with such clinical features and image findings has been described in previous reports.

Congenital tuberculosis after in vitro fertilization: suggestion for tuberculosis tests in infertile women in developing countries

“…However, TB tests before IVF are not routine. 5,6,10,13–22 Infertility caused by genital TB is common in countries with a high TB burden, and IVF is considered to be an effective treatment to improve fertility. Therefore, this may lead to more CTB cases without thorough TB tests before IVF.…”

Congenital tuberculosis after in vitro fertilization presenting with endobronchial granuloma

“…With the increasing availability of assisted reproductive technology, infertile women may become pregnant, which may lead to congenital TB infection in their neonates. 1 Three other sets of twins with congenital TB following in vitro fertilization have been reported. 3,6 In conclusion, the diagnosis of congenital TB should be considered in any neonate with pneumonia who fails to respond to conventional treatment and supportive therapy.…”

“…Early diagnosis of congenital TB is challenging because of nonspecific symptoms and poor sensitivity of diagnostic tests such as the tuberculin skin test (TST) and interferon-g release assay. 1 Endobronchial TB is quite common in children, although the incidence in unknown because bronchoscopy is not routinely performed. However, studies report bronchial involvement in 41%e63% of children with suspected TB.…”

A Perspective of the Diagnosis and Management of Congenital Tuberculosis

“…They may be accepted in combination with TST but should not be utilized as a substitution [9]. In contrast, Zheng et al [46] attested T-spot assay in their case, based on IFN- γ release assays (IGRAs) from specific T cells in vitro in response to stimulation of Mycobacterium tuberculosis antigens and which has objectified a positive result in a premature newborn, conceived by in vitro fertilization.…”