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Pre-extensively Drug-Resistant Congenital Tuberculosis in an Extremely Premature Baby

Alison Boast1,2,3, Jeu Ann How4, Charis Lau4,5

  • 1Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 8, 2023
PubMed

Insights

Congenital tuberculosis (TB) was rapidly diagnosed in a premature infant using molecular methods. Successful treatment involved novel drugs, bedaquiline and delamanid, offering new hope for treating this rare condition.

Area of Science:

  • Neonatology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Congenital tuberculosis (TB) is a rare and severe infection in newborns, often with poor outcomes.
  • Early diagnosis and effective treatment are critical for survival in extremely premature infants.

Observation:

  • A case of congenital TB was identified in an extremely premature neonate.
  • Rapid molecular detection revealed a pre-extensively drug-resistant (XDR) TB pattern.

Findings:

  • The infant was successfully treated with a novel regimen.
  • The treatment included bedaquiline and delamanid, marking their first use in congenital TB.

Implications:

  • This case demonstrates the efficacy of rapid molecular diagnostics for guiding treatment in congenital TB.
  • The successful use of bedaquiline and delamanid expands therapeutic options for drug-resistant congenital TB.
  • This approach may improve outcomes for infants with this challenging condition.

Keywords:
congenital tuberculosismultidrug resistantneonateprematuretherapeutic drug monitoring

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