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Asymptomatic congenital tuberculosis: A case report.


Meyer Sauteur, Patrick M; Marques-Maggio, Ewerton; Relly, Christa; Keller, Peter M; Clarenbach, Christian F; Berger, Christoph (2017). Asymptomatic congenital tuberculosis: A case report. Medicine, 96(29):e7562.

Abstract

RATIONALE: Congenital tuberculosis (TB) is described as a rare, but severe disease. In contrast to the cases with severe symptoms reported so far, we describe a child with asymptomatic congenital TB.
PATIENT CONCERNS: An 8-week-old girl was investigated because of newly diagnosed TB in her mother, which complained about cough since 21 weeks gestation. Lung biopsy tissue specimens of the mother revealed necrotizing granuloma with a single acid-fast bacillus (AFB) and Mycobacterium tuberculosis (MTB) was detected by polymerase chain reaction. Bronchoalveolar lavage was negative for AFB smear and culture, arguing against postnatal transmission of MTB. TB contact investigations were negative. The child, at the age of 8 weeks at first assessment, was in an excellent general condition and diagnosed with congenital TB by culture-positive lung TB and exclusion of postnatal transmission.
DIAGNOSES: The child fulfilled Cantwell criteria to diagnose congenital TB.
INTERVENTIONS: Ambulatory anti-tuberculosis treatment was initiated for 6 months.
OUTCOMES: The 18 months follow-up was uneventful.
LESSONS: This case of asymptomatic congenital TB in a young child illustrates the diagnostic difficulties in congenital TB and raises the question whether congenital TB is underestimated.

Abstract

RATIONALE: Congenital tuberculosis (TB) is described as a rare, but severe disease. In contrast to the cases with severe symptoms reported so far, we describe a child with asymptomatic congenital TB.
PATIENT CONCERNS: An 8-week-old girl was investigated because of newly diagnosed TB in her mother, which complained about cough since 21 weeks gestation. Lung biopsy tissue specimens of the mother revealed necrotizing granuloma with a single acid-fast bacillus (AFB) and Mycobacterium tuberculosis (MTB) was detected by polymerase chain reaction. Bronchoalveolar lavage was negative for AFB smear and culture, arguing against postnatal transmission of MTB. TB contact investigations were negative. The child, at the age of 8 weeks at first assessment, was in an excellent general condition and diagnosed with congenital TB by culture-positive lung TB and exclusion of postnatal transmission.
DIAGNOSES: The child fulfilled Cantwell criteria to diagnose congenital TB.
INTERVENTIONS: Ambulatory anti-tuberculosis treatment was initiated for 6 months.
OUTCOMES: The 18 months follow-up was uneventful.
LESSONS: This case of asymptomatic congenital TB in a young child illustrates the diagnostic difficulties in congenital TB and raises the question whether congenital TB is underestimated.

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Additional indexing

Item Type:Journal Article, not_refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > University Hospital Zurich > Institute of Pathology and Molecular Pathology
04 Faculty of Medicine > Institute of Medical Microbiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2017
Deposited On:23 Aug 2017 09:28
Last Modified:19 Feb 2018 08:26
Publisher:Lippincott Williams & Wilkins
ISSN:0025-7974
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1097/MD.0000000000007562
PubMed ID:28723785

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