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Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
[Congenital tuberculosis. Infrequent presentation of a common disease]
Ricardo S Dalamón1, Silvina N Cantelli, Diego Jaroslavsky
1Centro Neonatal y Pediátrico, Sanatorio y Maternidad Santa Isabel. ricardodalamon@yahoo.com
Insights
Congenital tuberculosis is a severe, rapidly progressive newborn disease. Diagnosis requires specific lesions, placental involvement, and exclusion of other exposures, as seen in a fatal case.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Congenital tuberculosis (CTB) is a rare but severe condition in newborns.
- CTB is distinct from neonatal tuberculosis due to specific diagnostic criteria including early-life lesions and maternal placental involvement.
Observation:
- A 20-day-old infant presented with fever, hepatoesplenomegaly, abdominal distension, and respiratory distress.
- Imaging revealed ascites, hepatosplenomegaly, portal lymphadenopathy, and thoracic micronodular infiltrates.
- Maternal history included pneumonia with pleural effusion during pregnancy.
Findings:
- Mycobacterium tuberculosis was confirmed post-mortem via gastric lavage, blood, and spleen cultures.
- The infant's presentation and autopsy findings were consistent with congenital tuberculosis.
Implications:
- This case highlights the critical need for early recognition and diagnosis of congenital tuberculosis in neonates presenting with severe, non-specific symptoms.
- Prompt identification and treatment are crucial, although outcomes remain challenging.
- Further research into diagnostic markers and therapeutic strategies for congenital tuberculosis is warranted.
Abstract:
Congenital tuberculosis is a severe rapidly progressive disease which differs from neonatal tuberculosis because patients present tuberculous lesions during their first weeks of life, primary hepatic complex or hepatic caseous granulomas, confirmation of tuberculosis in placenta or in maternal genital tract (uterus or adnexa), and exclusion of birth channel or postnatal exposure. We report a case of a 20 days newborn baby admitted to the neonatal unit with fever, hepatoesplenomegaly, abdominal distension and respiratory symptoms. Abdominal echography showed ascitis, diffuse hepatomegaly and splenomegaly, focal hipoecoical spleen images and portal lymphadenopathy. Thorax X-ray with micronodular infiltrates. Maternal pneumonia with pleural effusion was reported during pregnancy. Empirical treatment was initiated with 4 antituberculous drugs: isoniazid, rifampicin, pyrazinamide and ethambutol suspecting tuberculosis. She died the next day. M. tuberculosis was obtained in a gastric lavage culture, blood cultures and post mortem spleen puncture.
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