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[Congenital tuberculosis in a premature infant]
H G Limbach1, H J Jesberger, G Löffler
1Universitätsklinik für Kinder- und Jugendmedizin Homburg/Saar.
Insights
Congenital tuberculosis in a premature infant was diagnosed via stomach secretion analysis. Treatment with isoniazid and rifampicin successfully cured the infection, despite streptomycin resistance and developing cholestasis.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Tuberculosis
Background:
- Congenital tuberculosis is a rare but severe condition in newborns.
- Early diagnosis and prompt treatment are crucial for patient survival.
Observation:
- A premature infant (31 weeks gestation, 1300g) presented with suspected congenital tuberculosis at 5 days old.
- Mycobacterium tuberculosis was identified in gastric aspirates, correlating with abdominal symptoms and anemia.
Findings:
- The infant received a 3-month dual parenteral therapy (isoniazid and rifampicin) followed by 6 months of isoniazid monotherapy.
- The tuberculosis was successfully treated, although the Mycobacterium tuberculosis strain developed resistance to streptomycin.
- Cholestasis emerged as a complication during the initial phase of chemotherapy.
Implications:
- This case highlights the importance of considering congenital tuberculosis in at-risk neonates.
- Effective treatment regimens for congenital tuberculosis can be achieved with appropriate antibiotic selection.
- Monitoring for drug resistance and treatment-related complications like cholestasis is essential.
Abstract:
5 days after birth a premature baby of 1,300 g (31st week of gestation) was examined, because a congenital tuberculosis was suspected. In the stomach secretion mycobacterium tuberculosis could in fact be found. Abdominal symptoms as well as a post-natal anemia could be lead back to the infection. For three months a double parenteral therapy with INH (10 mg/kg/d) and Rifampicin (10 mg/kg/d) was carried through, then a mono therapy with INH for another 6 months. The bacillus had become resistant to streptomycin. At the beginning of the chemotherapy a cholestasis developed. The tuberculosis could be cured.