Perinatally Acquired Tuberculosis in a Neonate

Abstract

Objectives: To report a case of perinatal tuberculosis that appeared on the 21th day of life of an infant born to a mother with latent tuberculosis. Clinical Presentation and Intervention: A preterm male infant was born by spontaneous vertex delivery at 33 weeks gestational age to a 33-year-old primiparous Philippine woman. The infant was well until the 21st day of life when he developed recurrent episodes of cyanosis and bradycardia. A chest radiograph showed infiltrates which were thought to be bacterial in origin. Blood, urine, and cerebrospinal fluid cultures were normal. Tracheal aspirate revealed acid-fast bacilli by Ziehl-Neelsen stain, later confirmed to be Mycobacterium tuberculosis by culture in Lowenstein-Jensen medium. The mother was later diagnosed as a case of tuberculosis with symptoms, signs and radiologic manifestation of hilar lymphadenopathy with mild pleural effusion and positive tuberculin skin test. Both infant and mother were treated with intravenous isoniazid, intravenous rifampicin, oral pyrazinamide, and intravenous pyridoxine. Both recovered. Conclusion: A preterm male infant perinatally acquired tuberculosis, most likely by inhalation of the bacteria during delivery. Both infant and mother responded well to antituberculous treatment.

Tuberculosis perinatal

“…El foco pulmonar primario puede permanecer en estado latente hasta después del nacimiento, cuando mejora la oxigenación y el aumento en la circulación pulmonar puede estimular el crecimiento del Mycobacterium tuberculosis. 5 La aspiración o ingestión de líquido amniótico infectado resulta en la formación del complejo primario en los pulmones o tracto gastrointestinal, respectivamente 7,8 . Los órganos más comúnmente afectados son el hígado, el pulmón y los ganglios linfáticos 11 .…”

“…Una vez que se diagnostica la TB perinatal, el riesgo de propagación a través de la vía respiratoria a los trabajadores de la salud y otros niños es muy bajo, ya que los niños son paucibacilares 7 .…”

“…La mortalidad es alta, y varía entre el 2-60%, dependiendo de la demora diagnóstica y otros factores, como prematuridad o co-infección con VIH 7,13 .…”