Related Experiment Video
Updated: Jul 23, 2025
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
A Case of Community-Acquired Tuberculosis in an Infant Presenting with Pneumonia Refractory to Antibiotic Therapy
Audra N Iness1, Andrea T Cruz2,3, Scott R Dorfman4
1Baylor College of Medicine, Department of Pediatrics, Houston, TX.
Insights
Infant tuberculosis (TB) is challenging to diagnose, often presenting with non-specific symptoms. This case highlights the importance of considering TB in infants with persistent pneumonia and growth faltering, even without known exposure.
Area of Science:
- Pediatrics
- Infectious Diseases
- Radiology
Background:
- Infant tuberculosis (TB) is rare, potentially fatal, and difficult to diagnose due to non-specific symptoms.
- Community-acquired pneumonia is a common diagnosis in infants, but treatment failure warrants broader differential diagnoses.
Purpose of the Study:
- To report a case of miliary tuberculosis in a US-born infant with no known TB exposure.
- To emphasize the diagnostic challenges and clinical considerations for infant TB.
- To highlight the risk of central nervous system (CNS) involvement in disseminated TB.
Main Methods:
- Case report of a term infant presenting with respiratory distress and initial misdiagnosis of pneumonia.
- Diagnostic workup included chest radiography, QuantiFERON-TB Gold test, purified protein derivative (PPD) skin test, and CNS imaging.
- Treatment response and clinical course were monitored.
Main Results:
- The infant presented with respiratory distress, initially treated as community-acquired pneumonia without improvement.
- Imaging revealed findings suggestive of disseminated TB with CNS involvement.
- Diagnosis was confirmed via QuantiFERON and PPD tests, despite negative initial cerebrospinal fluid (CSF) studies.
Conclusions:
- In infants with treatment-refractory pneumonia and growth faltering, consider tuberculosis and other alternative etiologies.
- Disseminated TB poses a high risk for CNS involvement, necessitating brain imaging even with negative CSF results.
- Early and accurate diagnosis of infant TB is crucial for timely management and improved outcomes.
Abstract:
Infant tuberculosis (TB) is a rare but potentially deadly infection and difficult to diagnose, especially in infants who may present with non-specific symptoms. Here, we report a case of an United States-born term infant with community-acquired miliary TB and no confirmed TB exposure history. The patient initially presented with respiratory distress at seven weeks of life with chest radiograph showing a right lower lobe (RLL) infiltrate. After failing multiple courses of treatment for community-acquired pneumonia and developing growth faltering, the patient had imaging findings suggestive of TB infection with CNS involvement. The diagnosis of TB was confirmed by QuantiFERON and purified protein derivative (PPD). In infants who fail conventional treatment for bacterial pneumonia, the differential should be broadened to consider alternative etiologies. Additionally, brain imaging should be performed in cases of disseminated TB despite negative cerebrospinal fluid (CSF) studies since these patients are at high risk of central nervous system (CNS) involvement.
Topics:
Tuberculosis, pneumonia, pediatrics, growth faltering.
More Related Videos
11:32Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Related Concept Videos
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...