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Infectious Diseases
Challenges in diagnosing disseminated congenital tuberculosis in a neonate: outcome and maternal treatment opportunity
  1. Borra Ranganath1,
  2. Monica Selvan2,
  3. Kiranben Chaudhari1 and
  4. Usha Devi1
  1. 1Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Usha Devi; dr.ushaa{at}gmail.com

Abstract

In India, congenital tuberculosis (TB) accounts for 1%–3% of the TB burden. We present the case of a term neonate admitted with respiratory distress, hepatosplenomegaly and abnormal coagulation profiles. The neonate’s condition rapidly deteriorated, progressing to respiratory failure within 72 hours of admission. Tuberculosis-specific tests (TB PCR and culture) in the neonate confirmed the diagnosis of disseminated congenital TB. However, the results arrived after the neonate succumbed to multiorgan failure following a brief hospital stay. Maternal chest imaging after these results revealed miliary TB and she was started on anti-TB treatment. Despite the concerning signs, congenital TB was not initially suspected due to the absence of relevant maternal history and the overlapping features with other infections. As a result, the initial differentials considered were bacterial sepsis, perinatal viral infections and immunodeficiency. This case underscores the need for earlier suspicion of congenital TB, particularly in TB-endemic areas, to avoid adverse outcomes.

  • Infections
  • TB and other respiratory infections
  • Neonatal intensive care

https://doi.org/10.1136/bcr-2024-262698

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    Footnotes

    • X @@BorraRanganath, @UshaDevi_Neo

    • Contributors BR, MS and KC were responsible for drafting of the text; BR, MS, KC and UD were involved in sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms; and UD critically revised important intellectual content. UD is the guarantor. The following authors gave final approval of the manuscript: BR, MS, KC, and UD.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.