Congenital Tuberculosis: A Newborn Case Report With Rare Manifestation

Congenital tuberculosis is an infrequently encountered condition and only 300 cases were reported in the literature till 1989. There are no specific signs and symptoms pathognomonic for congenital TB, and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period.

In this paper we report on a case of congenital TB in a newborn who was admitted to our clinic with seizures and intraventricular hemorrhage (IVH) due to TB meningitis. Her mother was diagnosed with active pulmonary TB and treated with a multi-drug anti-tuberculosis regimen. Her screening for human immunodeficiency virus (HIV) was negative. Cerebrospinal fluid was collected and showed protein levels at 300 mg/dL, glucose at 27 mg/dL (serum glucose level was 76 mg/dL), many RBC, and a positive result for acid-fast bacilli on smear microscopy, all of which were compatible with tuberculous meningitis.

It is important to consider TB meningitis in newborns with perinatal IVH and concomitant hydrocephalus particularly when the mother has a history of TB prior to or during pregnancy.