Congenital tuberculosis: a case report

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Congenital tuberculosis (Mycobacterium tuberculosis infection) is a rare but severe condition.
• It presents significant diagnostic and therapeutic challenges, particularly in neonates and infants.
• Maternal tuberculosis is a primary risk factor for congenital transmission.

Observation:

• A two-month-old infant presented with fever, dyspnea, and a diffuse micronodular pattern on chest X-ray, with a history of maternal tuberculosis.
• Initial triple-drug anti-tuberculosis therapy led to jaundice and elevated liver enzymes, indicating drug intolerance.
• Alternative treatment regimens failed to resolve the infant's persistent fever.

Findings:

• Increasing the dosage of isoniazid (INH) and rifampicin (RMP) in the anti-tuberculosis regimen resulted in the resolution of fever.
• The infant was successfully treated and cured of congenital tuberculosis.
• This case underscores the complexities in managing congenital tuberculosis, especially concerning drug tolerance and efficacy.

Implications:

• Highlights the need for careful monitoring and individualized treatment adjustments in congenital tuberculosis.
• Suggests that optimizing anti-tuberculosis drug dosages may be crucial for successful treatment in infants with intolerance.
• Emphasizes the importance of developing specific clinical protocols to address the diagnostic and therapeutic difficulties of congenital tuberculosis.