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Asymptomatic congenital tuberculosis: A case report
Patrick M Meyer Sauteur1, Ewerton Marques-Maggio, Christa Relly
1Division of Infectious Diseases and Hospital Epidemiology Children's Research Center, University Children's Hospital Zurich Division of Clinical Pathology, University Hospital Zurich Institute of Medical Microbiology Swiss National Center for Mycobacteria, University of Zurich Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Insights
A rare case of asymptomatic congenital tuberculosis (TB) in an infant highlights diagnostic challenges. This finding suggests congenital TB may be underdiagnosed, emphasizing the need for increased awareness and diagnostic vigilance.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Congenital tuberculosis (TB) is a rare but severe condition.
- Previous reports focused on symptomatic cases.
Observation:
- An 8-week-old infant presented with asymptomatic congenital TB.
- Diagnosis was confirmed via culture-positive lung TB and exclusion of postnatal transmission, meeting Cantwell criteria.
Findings:
- The infant received 6 months of ambulatory anti-tuberculosis treatment.
- An 18-month follow-up showed an uneventful recovery.
Implications:
- This case underscores the diagnostic difficulties associated with congenital TB.
- It raises questions about the potential underestimation of congenital TB prevalence.
Rationale:
Congenital tuberculosis (TB) is described as a rare, but severe disease. In contrast to the cases with severe symptoms reported so far, we describe a child with asymptomatic congenital TB.
Patient Concerns:
An 8-week-old girl was investigated because of newly diagnosed TB in her mother, which complained about cough since 21 weeks gestation. Lung biopsy tissue specimens of the mother revealed necrotizing granuloma with a single acid-fast bacillus (AFB) and Mycobacterium tuberculosis (MTB) was detected by polymerase chain reaction. Bronchoalveolar lavage was negative for AFB smear and culture, arguing against postnatal transmission of MTB. TB contact investigations were negative. The child, at the age of 8 weeks at first assessment, was in an excellent general condition and diagnosed with congenital TB by culture-positive lung TB and exclusion of postnatal transmission.
Diagnoses:
The child fulfilled Cantwell criteria to diagnose congenital TB.
Interventions:
Ambulatory anti-tuberculosis treatment was initiated for 6 months.
Outcomes:
The 18 months follow-up was uneventful.
Lessons:
This case of asymptomatic congenital TB in a young child illustrates the diagnostic difficulties in congenital TB and raises the question whether congenital TB is underestimated.
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