A Case of Congenital Tuberculosis in a Tertiary Care Hospital

Ishrat Jahan,Laisha Yeasmin,Mehedi Parvez

doi:10.3329/jemc.v1i2.11469

Abstract

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek-old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic management of congenital tuberculosis and alerts for development of protocols that foresee these difficulties. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11469 J Enam Med Col 2011; 1(2): 85-87

Highlights

Congenital tuberculosis is considered when infection with tubercle bacilli takes origin either during the intrauterine life or before complete passage through birth canal.[1]
Infection has clinically been thought to be acquired in three ways: (a) transplacentally, with primary complex in liver, (b) aspiration of infected amniotic fluid during passage through birth canal, when lungs are primary foci and (c) ingestion of infected materials where the primary focus is the gut
We are reporting a case of congenital tuberculosis

Summary

Introduction

Congenital tuberculosis is considered when infection with tubercle bacilli takes origin either during the intrauterine life or before complete passage through birth canal.[1]. When the infant was two months of age, he developed several episodes of convulsion. He was born to a 32-year-old, first gravida mother at home by normal vaginal delivery and the patient was healthy at birth. Initial chest radiography showed patchy opacity on left lung field. He was shown to several physicians and had received several antibiotics without improvement. She had been suffering from cough for three months in last trimester of pregnancy and was diagnosed as a case of pulmonary tuberculosis. Antitubercular treatment (ATT) was initiated after the diagnosis was confirmed. ATT was started using four drug regimen, but the baby died on third day of ATT

Discussion

Conclusion