RESUMO
The presentation of congenital tuberculosis (TB) is varied, with frequent extrapulmonary disease, but congenital spinal TB has been rarely reported. We present 2 cases of spinal TB (1 confirmed, 1 clinical diagnosis) in HIV-exposed infants with likely congenital transmission. Increased vigilance for congenital TB, including uncommon presentations, is needed, particularly in countries with high HIV and TB prevalence.
Assuntos
Infecções por HIV/complicações , Transmissão Vertical de Doenças Infecciosas , Tuberculose da Coluna Vertebral/congênito , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Antituberculosos/uso terapêutico , Infecções por HIV/microbiologia , Humanos , Lactente , Masculino , Mães/estatística & dados numéricos , Moçambique , Radiografia , Tuberculose da Coluna Vertebral/virologiaAssuntos
Tuberculose Latente/transmissão , Complicações Infecciosas na Gravidez/microbiologia , Coluna Vertebral/microbiologia , Tuberculose da Coluna Vertebral/patologia , Adulto , República Democrática do Congo , Feminino , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Tuberculose Latente/complicações , Gravidez , Risco , Coluna Vertebral/patologia , Tuberculose da Coluna Vertebral/congênito , Tuberculose da Coluna Vertebral/diagnósticoRESUMO
Spinal tuberculosis constitutes 50% of all musculoskeletal tuberculosis. However, literature regarding congenital spinal tuberculosis is very scanty. Congenital spinal tuberculosis was diagnosed in a two-month-old child on the basis of age at presentation (gibbus since three weeks of age), hepatomegaly, raised ESR, radiological destruction of D10-D11 vertebrae, asymptomatic maternal endometrial tuberculosis and tuberculous histopathology from CT guided biopsy specimen from D10 vertebra. Both child and mother were treated by antitubercular treatment. Child improved symptomatically, gibbus became less prominent and ESR became normal at the end of one year of treatment. Patient had no recurrence during last two years of follow-up. This is the first case of congenital tuberculosis of spine with a documented source of infection from asymptomatic maternal endometrial tuberculosis. CT guided core biopsy from vertebra/aspiration from the paravertebral abscess help in early diagnosis and treatment to reduce neurological morbidity and mortality. Endometrial biopsy help in establishing the diagnosis of congenital tuberculosis and adequate antitubercular treatment in such cases may provide protection to fetus in subsequent pregnancy.
Assuntos
Transmissão Vertical de Doenças Infecciosas , Tuberculose dos Genitais Femininos/complicações , Tuberculose da Coluna Vertebral/diagnóstico , Doenças Uterinas/complicações , Feminino , Humanos , Lactente , Tuberculose dos Genitais Femininos/diagnóstico , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/congênito , Tuberculose da Coluna Vertebral/transmissão , Doenças Uterinas/diagnósticoRESUMO
Perinatal/congenital tuberculosis is a rare entity, even in human immunodeficiency virus (HIV) endemic populations, and is uniformly fatal if untreated. The liver and the lungs are the most commonly involved organs in this variety of tuberculosis and the spine is a rare site. We report the first case of spine tuberculosis with paravertebral abscess in a neonate who was only 3 weeks of age. The imaging studies, namely radiography, sonography, computed tomography (CT)-guided aspiration and magnetic resonance imaging (MRI), facilitated rapid diagnosis and early institution of chemotherapy. We highlight the role of imaging evaluation in the diagnostic armamentarium for tuberculosis of the newborn, as early diagnosis followed by appropriate treatment resulted in an excellent recovery in our patient.
