A Case of Miliary Perinatal Tuberculosis in a Preterm Newborn Infant Presenting as Peritonitis

Perinatal tuberculosis (TB) is a rare disease with nonspecific clinical symptoms that can result in delayed treatment, and contribute to high morbidity and mortality. We report a case of perinatal TB in a 25-day-old newborn who presented with fever, respiratory distress, disseminated intravascular coagulation (DIC), and marked abdominal distension with hepatosplenomegaly. Further workup revealed culture negative sepsis, peritonitis, and diffuse nodular infiltrate in the lungs, liver, and spleen. After an extensive diagnostic workup for potential gastrointestinal causes of sepsis, the diagnosis of TB was finally established via paracentesis and maternal testing. Our objective is to draw attention to the multifaceted clinical manifestations of perinatal TB despite classically being associated with pulmonary symptoms; extensive gastrointestinal involvement should not exclude perinatal TB from the differential during the workup of culture-negative sepsis.