Congenital tuberculosis: a case report / 中华围产医学杂志

ABSTRACT

We reported the diagnosis and treatment of a male infant with congenital tuberculosis. He was a small for gestational age (SGA) and formula-fed baby born virginally at the gestational age of 36 weeks. He was admitted to hospital at the age of 28 days for fever. His mother experienced untreated low fever and cough at 24-28 gestational weeks and was postnatally diagnosed as having pulmonary tuberculosis and tuberculosis encephalitis. Physical examination of the baby found hepatomegaly and splenomegaly on admission and the lab results indicated anaemia, elevated C-reactive protein (CRP) and impaired liver function. Acid-fast Bacillus was detected in gastric fluid smear test using acid-fast staining. The detection of T-cell ELIspots in tuberculosis infection (T-SPOT.TB) test was positive. Chest/abdominal X-rays showed multiple nodular and linear shadows in both lungs. Abdominal MRI revealed abnormal signals of diffuse nodular lesions in the liver and spleen. X-rays of the long bones showed few periosteal reactions in both femurs. Quadruple anti-tuberculosis therapy with isoniazid, rifampicin, pyrazinamide and amikacin was initiated on admission and the patient experienced fluctuating body temperature, poor weight gain and CRP level ranging from 15 to 22 mg/L. Though the pulmonary lesion subsided after the treatment, no significant change occured in hepatic or splenic lesions. The baby boy was discharged from the hospital at the request of his parents on 39 d and lost to follow-up.