Infantile pulmonary tuberculosis: the great mimic

Varik, Roma Subhash; Shubha, Attibele Mahadevaiah; Lewin, Maria; Berndt, Alexander; Kini, Usha; Das, Kanishka

doi:10.1007/s00383-012-3084-8

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…In total, 67.39% of patients developed symptoms within 3 weeks of birth, and patients who developed symptoms in fewer than 7 days accounted for 19.56% of all patients with congenital tuberculosis. In addition, disseminated Bacilli Calmette Guerin (BCG) disease should be excluded [12]. Because BCG vaccination is completed within 24 h of birth in China, the onset time for disseminated BCG disease may overlap with that of congenital tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of congenital tuberculosis: a systematic review of 92 cases

Liu

Tao

2019

Orphanet J Rare Dis

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Background Congenital tuberculosis is rare and carries a high mortality rate. Our objective was to summarize the current experience of the diagnosis and treatment of patients with congenital tuberculosis. Methods In total, 73 reported cases of congenital tuberculosis published in Chinese and 19 patients with congenital tuberculosis admitted to West China Second University Hospital, Sichuan University, were retrospectively reviewed. Results Sixty-four male and 28 female patients were identified. The majority of the patients were less than 3 weeks old at the time of presentation (range, 0–67 days). With regard to the tuberculosis type, 89 patients had pulmonary tuberculosis, and 20 patients had hepatic tuberculosis. There was active tuberculosis in 71 mothers, no tuberculosis in 12 mothers, and an unknown history of tuberculosis in 9 mothers. Fever, cyanosis, jaundice, shortness of breath, cough, pulmonary moist rales, hepatomegaly, splenomegaly and abdominal distention were the main clinical symptoms at the time of presentation. The abnormal ratios of chest, abdomen and head radiographic images were 97.53, 75 and 81.25%, respectively. The positive rates of acid-fast staining of sputum smears and tuberculosis bacillus DNA were 62.50 and 66.67%, respectively. The misdiagnosis rate was 59.78%. The overall mortality due to congenital tuberculosis was 43.48%. Respiratory failure was the most common cause of death. Sixty-five patients received anti-tuberculosis therapy, and of those, only 16 (15.38%) died. Conclusions The clinical manifestations and radiographic findings of congenital tuberculosis are nonspecific. It is important to thoroughly evaluate the mothers of infants with suspected congenital tuberculosis. Good outcomes can be achieved in infants with the early identification of congenital tuberculosis and early administration of anti-tuberculosis treatment.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of congenital tuberculosis: a systematic review of 92 cases

Liu

Tao

2019

Orphanet J Rare Dis

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“…In clinical practice, due to differences in individuals’ immune functions, the time of symptom onset varied significantly ( Schaaf et al, 2010 ). Varik et al (2012) reported the symptoms of congenital tuberculosis occurred within 3 weeks after birth, and the average age of onset was 28 days. In our case, the 19-day-old male presented fever and tachypnea as well as signs of respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Surveillance of Neonatal Infections by Metagenomic Next-Generation Sequencing

et al. 2022

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Microbial infections cause significant morbidity and mortality in neonates. Metagenomic next-generation sequencing is a hypothesis-free and culture-free test that enables broad identification of pathogens and antimicrobial resistance genes directly from clinical samples within 24 h. In this study, we used mNGS for etiological diagnosis and monitoring the efficacy of antibiotic treatment in a cohort of neonatal patients with severe infections. The median age was 19.5 (3–52) days, median gestational age was 37.96 (31–40+3) weeks, and the median birth weight was 3,261 (1,300–4,300) g. The types of infectious diseases included pneumonia, sepsis, and meningitis. mNGS reported microbial findings in all cases, which led to changes in antibiotic treatment. These included cases of Mycobacterium tuberculosis, Legionella pneumophila, and Bacillus cereus. Eight of ten infants recovered after antibiotic adjustment and showed normal development during follow-up. On the other hand, neurological retardation was seen in two infants with meningitis. mNGS enabled etiological diagnosis and guided antibiotic therapy when all conventional methods failed to discover the culprit. It has the potential to cut down the overall cost and burden of disease management in neonatal infections.

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A rare cause of airway obstruction: Mediastinal cyst secondarily infected with Mycobacterium tuberculosis

et al. 2018

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Mediastinal cysts are mostly congenital, but rarely, infections and malignancies can cause cystic degeneration of enlarged mediastinal lymph nodes. Diagnosis is challenging as the presenting symptoms are nonspecific. Surgical resection is the reference modality both for diagnosis and management. Secondary infection of mediastinal bronchogenic cyst with Mycobacterium tuberculosis is rare. Herein, we describe a young male who was managed as bronchial asthma with inhalational bronchodilators and glucocorticoids. Computed tomography revealed a cystic lesion in the subcarinal region. Endobronchial ultrasound-guided transbronchial needle aspiration was done to perform diagnostic and therapeutic aspiration of the cyst that showed infection with M. tuberculosis. A subsequent surgical resection confirmed the cystic lesion to be a bronchogenic cyst.

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Infantile pulmonary tuberculosis: the great mimic

Cited by 3 publications

References 26 publications

Diagnosis and treatment of congenital tuberculosis: a systematic review of 92 cases

Diagnosis and treatment of congenital tuberculosis: a systematic review of 92 cases

Diagnosis and Surveillance of Neonatal Infections by Metagenomic Next-Generation Sequencing

A rare cause of airway obstruction: Mediastinal cyst secondarily infected with Mycobacterium tuberculosis

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