Onset of 26th day after birth, intermittent cough with pulmonary multifocal nodules

Abstract

Objective To improve the understanding of neonatal-onset pulmonary tuberculosis. Methods The clinical features, laboratory examination and imaging were analyzed in 2 cases with neonatal-onset pulmonary tuberculosis in the Respiratory Department of Beijing Children′s Hospital, Capital Medical University. Results The 2 patients were premature twins, were born at 33+ 3 weeks of gestation, presented with intermittent cough and transient fever on 26 days after birth.Chest CT scan showed pulmonary multifocal nodules.One case was complicated with pleural effusion, atelectasis and no effectiveness with antibiotics.The untypical pathogen infection was considered.The result of PPD was negative, the result of interferon gamma release array, gastric acid fast staining and mycobacterium tuberculosis culture were positive, finally they were diagnosed with pulmonary tuberculosis. Conclusions The clinical features and imaging of neonatal tuberculosis are always untypical and PPD is negative, which brings difficulties to clinical diagnosis.We should take untypical pathogens into account, such as tuberculosis, when some diseases cannot be explained by common pathogens. Key words: Pulmonary multifocal nodules; Pulmonary tuberculosis; Interferon-γ release array