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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 03

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Ginecol Obstet Mex 2021; 89 (03)

Congenital tuberculosis. A case report

Farías-Vela AP, Daza-Leguizamón DY, Aragón-Mendoza RL, Pulido-Rodríguez MF

Language: Spanish
References: 19
Page: 267-273
PDF size: 204.84 Kb.


ABSTRACT

Background: Congenital tuberculosis is an exceptional bacterial infection caused by Mycobacterium tuberculosis. It is transmitted vertically from mother to fetus in 16% of cases. It can be by two routes: transplacental through the umbilical vein or by contamination of the amniotic fluid that can be aspirated or ingested by the fetus. Its diagnosis is challenging, with nonspecific symptoms. It is suspected in neonates born to mothers with tuberculosis; mortality is high.
Clinical case: A 30-year-old patient with a history of mild intermittent asthma treated with salbutamol, two pregnancies, one delivery and one miscarriage and an ongoing gestation of 35 weeks at the Hospital Universitario de la Samaritana. She consulted due to fever associated with respiratory symptoms, with positive bacilloscopy. Pulmonary tuberculosis was diagnosed. During hospitalization she had preterm labor, with live newborn, which was isolated due to maternal diagnosis. Prophylactic treatment with isoniazid was indicated; congenital tuberculosis was diagnosed by positive PCR for Mycobacterium tuberculosis in gastric juice. Treatment was complemented with rifampicin, pyrazinamide and ethambutol, with which the clinical response was favorable.
Conclusion: Congenital tuberculosis is a rare disease, with nonspecific symptoms. It may be suspected in the newborn child of a mother with this diagnosis or without response to traditional antibiotic treatment or supportive therapy in neonatal intensive care units. Diagnosis is based on microbiological detection of the bacillus. Early treatment is associated with better perinatal outcomes and decreased mortality.


REFERENCES

  1. Newberry D, Robertson T. Congenital tuberculosis. A new concern in the neonatal intensive care unit. Advances in Neonatal Care. 2018; 18(5): 341-49. http://doi:10.1097/ ANC.0000000000000555.

  2. Inda L, Pérez MG, Taicz M, Casimir L, Fernández R, González F. Tuberculosis congénita reporte de un caso. 2014; 21 (2): 201-3. https://www.medicinainfantil.org.ar/images/ stories/volumen/2014/xxi_2_201.pdf

  3. Saramba MI, Zhao D. A Perspective of the diagnosis and management of congenital tuberculosis. Journal of Pathogens. 2016, Article ID 8623825, 8 page. https://doi. org/10.1155/2016/8623825

  4. Salud IN de. Informe de evento tuberculosis, periodo epidemiológico XIII. 2019; 7–8. https://www.ins.gov.co/ buscador- eventos/boletinepidemiologico/2019_Boletin_ epidemiologico_semana_52.pdf

  5. Taweevisit, M., Nisagornsen, C., & Thorner, P. S. Intrauterine tuberculosis manifesting as acute chorioamnionitis: a case report and review of the literature. Pediatric and Developmental Pathology. 2015; 18 (4): 335-38. https:// doi:10.2350/15-02-1607-cr.1

  6. Li C, Liu L, Tao Y. Diagnosis and treatment of congenital tuberculosis: a systematic review of 92 cases. Orphanet J Rare Dis. 2019; 14 (1): 131. https://doi.org/10.1186/ s13023-019-1101-x

  7. Mora V, Cala L. Tuberculosis congénita, tras un enemigo oculto. Infectio. 2016; 20 (3): 172-75. http://dx.doi. org/10.1016/j.infect.2015.09.003.

  8. De La Fuente J, Arévalo R, Velazco V, Agueda M, Tórico P. Tuberculosis congénita. conocerla para enfrentarla. Rev Med La Paz. 2017; 23 (1). http://www.scielo.org.bo/ scielo.php?Script=sci_arttext&pid=S1726895820170000 08&lng=es.

  9. Tejerina H, Diaz M, Cordero J, Gutierrez M, Conde Y. Tuberculosis congénita: presentación de un caso clínico y revisión de la literatura. Rev Soc Bol Ped 2015; 54: 14-7. http://www.scielo.org.bo/scielo.php?Script=sci_ arttext&pid=S1024-06752015000100004&lng=es.

  10. Chang C, Wu P, Yeh C, Wong K, Wang Ch, Chang C. Congenital tuberculosis: case report and review of the literature. Journal Paediatrics and International Child Health. 2018; 38 (3): 216-19. https://doi.org/10.1080/20469047.2017 .1315912

  11. Meyer P, Marquez E, Relly C, Keller P, Clarencach C, Berger C. Asymptomatic congenital tuberculosis. A case report. Medicine: 2017; 96 (29): e7562. https://doi: 10.1097/ MD.0000000000007562

  12. Ferreras A, Caro P, Moreno D, Pérez F. Perinatal tuberculosis: is it a forgotten desease? The Pediatric Infectious Disease Journal. 2018; 37 (3): e81–e83. https://doi:10.1097/ inf.0000000000001830

  13. Cifuentes Y, Murcia M, Piar J, Pardo P. Microcalcificaciones cerebrales en un recién nacido con tuberculosis congénita. Biomédica 2016; 36: 22-8. http://dx.doi.org/10.7705/ biomedica. v36i1.2509

  14. Sen V, Selimo H, Aktar F, Uluca U, karabel M, Gürkan M. Congenital tuberculosis: presentation of a rare case. Arch Argent Pediatr 2015; 113 (2): e101-e105. http://dx.doi. org/10.5546/aap.2015.e101

  15. Locham M, Shaw S, Dalal S, Gupta B. Case Report: congenital tuberculosis in a neonate. Medical Journal Armed Forces India 2019; 75: 96-98. https://doi.org/10.1016/j. mjafi.2017.11.003

  16. Sáenz J, Karam J. Jamaica L. Caso clínico: tuberculosis perinatal. Boletín Médico del Hospital Infantil de México. 2015; 72 (1): 61-65. https://doi.org/10.1016/j.bmhimx.2015.01.009

  17. Solorzano F. Tuberculosis congénita : un reto a vencer. Boletín Médico del Hospital Infantil de México. 2015; 72 (1). 3-4. https://doi.org/10.1016/j.bmhimx.2015.02.006

  18. Snow K, Bekker A, Huang G. Graham S. Tuberculosis in pregnant women and neonates: A meta-review of current evidence. Paediatric Respiratory Reviews 2020. https://doi. org/10.1016/j.prrv.2020.02.001

  19. Macias C, Monedero I. TB or not TB? Challenges in diagnosing and treating maternal and neonatal tuberculosis. Int J Tuberc Lung Dis. 2019; 23 (3): 280-82. https://doi. org/10.5588/ijtld.18.0548




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