Korean J Pediatr.  2016 Nov;59(Suppl 1):S64-S67. 10.3345/kjp.2016.59.11.S64.

Congenital miliary tuberculosis in an 18-day-old boy

• Lee JS
• Lim CH
• Kim E
• Lim H
• Lee Y
• Choung JT
• Yoo Y

• KMID: 2362258
• DOI: http://doi.org/10.3345/kjp.2016.59.11.S64

Abstract

Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day. Chest X-ray showed diffuse fine bilateral infiltration. Clinically, pneumonia or sepsis was suspected. Respiratory symptoms and chest X-ray findings worsened despite empirical antibiotic therapy. The lungs showed miliary infiltration suggestive of TB. Gastric aspirates were positive for M. tuberculosis. Respiratory distress and fever were gradually improved after anti-TB medication. Congenital TB is difficult to detect because of minimal or no symptoms during pregnancy and nonspecific symptoms in neonates. Hence, clinicians should suspect the possibility of TB infection even if neonates have non-specific symptoms. Early diagnosis and meticulous treatment are required for the survival of neonates with TB.

Keyword

Congenital tuberculosis; Miliary pattern; Neonate

MeSH Terms

Amniotic Fluid
Early Diagnosis
Female
Fetus
Fever
Humans
Infant
Infant, Newborn
Jaundice
Lung
Male*
Mortality
Mothers
Mycobacterium tuberculosis
Parturition
Pneumonia
Pregnancy
Rare Diseases
Sepsis
Thorax
Tuberculosis
Tuberculosis, Miliary*