Congenital tuberculosis: a case report

Congenital tubercolosis is an unusual and severe clinical pattern of tuberculosis presentation of Mycobacterium tuberculosis infection. Furthermore, it usually has a difficult treatment. We report a two-month-old male infant who presented with fever, dyspnea and a diffuse micronodular pattern at x-ray; mother with severe tuberculosis. Treatment with the triple drug regimen was initiated, but the child developed jaundice and an increase in liver enzymes on various occasions during treatment. A regimen specifically developed for cases of intolerance was initiated but there was no improvement in hyperthermia. Finally, the dose of INH and RMP was increased, the fever receded and the child was cured. This case remarks difficulties on diagnosis and therapeutic management about this important severe disease in public health, and alert for development of protocols that foresee these difficulties.

Perinatal tuberculosis: a diagnostic challenge

Despite the high prevalence of tuberculosis in adults and children, the congenital and perinatal forms of tuberculosis are rare. In Brazil, there has been only one published case of congenital tuberculosis and two cases of the perinatal form of this disease. We report a case of perinatal tuberculosis presenting with pneumonia. Alcohol-acid-resistant bacilli were found in the gastric lavage. Diagnosis of this disease presentation requires a high index of suspicion.

Congenital Tuberculosis: Report of an Autopsy Case

An autopsy case of congenital tuberculosis is described in a 41-day-old female infant who was born to a mother having active pulmonary tuberculosis. The primary complex was seen in the liver and portal lymph nodes, and there was a generalized miliary dissemination including lung, liver, spleen, pancreas, adrenals, thyroid, thymus, kidneys, brain, and bowel. The organism was confirmed to be Mycobacterium tuberculosis. The tubercles were histopathologically of various chronicity and characterized by massive caseation and fairly poor peripheral lymphohistiocytic reaction. Giant cell response was also minimal. It should be stressed that although rare, tuberculosis is still an important disease in Korea that can involve fetus or newborn infants if pregnant women are untreated or unnoticed for her tuberculosis.

Tuberculose na infância: aspectos controversos / Tuberculosis in childhood: controversial aspects

Os autores comentam quatro aspectos controversos do diagnóstico da tuberculose na infância: a tuberculose congênita, o PPD em vacinados com BCG intradérmico, o diagnóstico bacteriológico e a conduta em pneumonias de evoluçäo lenta supostamente tuberculosas. A tuberculose na criança oferece, quase sempre, dificuldade diagnóstica para o pediatra e/ou pneumologista devido à baixa positividade bacteriológica