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2012, Número 2

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Enf Infec Microbiol 2012; 32 (2)


Tuberculosis congénita: a propósito de tres casos

León RÁR, Batarse RJ, Serrano BC

Idioma: Español
Referencias bibliográficas: 39
Paginas: 81-87
Archivo PDF: 216.04 Kb.


RESUMEN

La tuberculosis congénita se caracteriza por granuloma hepático y exclusión de exposición postnatal. Se presentan tres casos, dos confirmados y un tercero por sospecha epidemiológica.
Casos clínicos A. Masculino 21 días edad, con neumonía de focos múltiples y mala respuesta al tratamiento, estudio de extensión con Ziehl-Neelsen positivo. Madre fallecida por tuberculosis TB meníngea.
B. Femenino 5 meses; con neumonía de focos múltiples sin mejoría tras el tratamiento, complicada con insuficiencia respiratoria, PPD (Derivado Proteico Purificado) no reactivo, aspirado bronquial con BAAR (Bacilos Ácido-Alcohol Resistentes) positivo dos días previos a su fallecimiento. Autopsia con granuloma tuberculoso en hígado, bazo y caverna en pulmón. Madre con TB miliar.
C. Masculino 5 meses; gemelo caso previo, neumonía apical recurrente inicia tratamiento antifímico posterior a fallecimiento de hermana con mejoría clínica y radiológica.
Conclusión. Se hace hincapié en la sospecha clínica y epidemiológica de TB congénita en lactante con neumonía recurrente, bajo peso o desnutrición aguda severa y la sospecha de enfermedad materna.


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