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[An infant with tuberculosis who previously contacted an infant with congenital tuberculosis]

Shinya Kondo1, Gen Nishimura

  • 1Division of Respiratory Disease, Tokyo Metropolitan Children's Hospital, Japan. shykondo@chp-kiyose-tokyo.jp

Kekkaku : [Tuberculosis]
|November 24, 2004
PubMed

Insights

A toddler with healed tuberculosis was detected via a positive tuberculin skin test before BCG vaccination. Abdominal imaging showed calcifications, suggesting potential infection from an infant with congenital tuberculosis in the NICU.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Radiology

Background:

  • Tuberculosis (TB) screening is crucial in infants, even those asymptomatic.
  • Bacille Calmette-Guérin (BCG) vaccination is a standard preventive measure for TB.
  • Congenital tuberculosis poses a diagnostic challenge, especially in neonates.

Observation:

  • A one-year-old male infant presented with a positive tuberculin skin test (TST) prior to scheduled BCG vaccination.
  • Abdominal computed tomography (CT) revealed hepatic, splenic, and lymph node calcifications.
  • Chest imaging was notably normal, indicating extrapulmonary TB manifestations.

Findings:

  • The infant's findings suggest a history of healed tuberculosis, likely acquired during a previous NICU stay.
  • Potential sources of infection include an intubated infant with congenital tuberculosis or an untreated maternal case.
  • Calcifications in abdominal organs and lymph nodes are indicative of disseminated or extrapulmonary TB.

Implications:

  • This case highlights the importance of considering extrapulmonary TB in infants with unexplained calcifications.
  • Periodic contact investigations are vital for infants exposed to congenital TB cases in healthcare settings.
  • Early detection and management of TB in infants are critical due to their underdeveloped cell-mediated immunity.

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