ABSTRACT

Infants may develop congenital tuberculosis from an infectious mother or acquire the disease postnatally by contact with an infectious adult. Delayed diagnosis is common, especially in infants under 1 year of age, and, if unrecognised, there is an increased risk of death. A 2.5-month-old boy presented with respiratory distress, small inhomogeneous opacities in both lungs and hepatosplenomegaly mimicking sepsis. He had received BCG vaccination and there was no history of contact with tuberculosis (TB). He had had fever since 1 month of age for which there had been several outpatient visits. Gastric aspirate cartridge-based nucleic acid amplification test (CBNAAT) confirmed TB and sonological evaluation demonstrated multiple granulomata in the liver and spleen, and a liver biopsy supported TB. He responded well to 12 months of anti-tuberculous treatment. The mother’s tuberculin test, chest radiograph and endometrial biopsy showed no evidence of TB. There was no history of tuberculous contact with close family members. Despite the lack of proof of current tuberculous TB infection in the mother, it is likely that the infant had congenital TB.

摘要

婴儿可能因感染性母亲而患上先天性肺结核，或通过与感染性成人接触而在出生后患上这种疾病。延迟诊断很常见，特别是在 1 岁以下的婴儿中，如果未被识别，死亡风险会增加。一名 2.5 个月大的男孩出现呼吸窘迫、双肺小的不均匀混浊和类似败血症的肝脾肿大。他曾接种卡介苗，无结核病（TB）接触史。他从 1 个月大开始发烧，曾多次门诊就诊。基于胃抽吸试剂盒的核酸扩增试验 (CBNAAT) 证实为结核病，声学评估显示肝脏和脾脏中存在多发性肉芽肿，肝活检支持结核病。他对 12 个月的抗结核治疗反应良好。母亲的结核菌素试验、胸片和子宫内膜活检均未显示结核病证据。与近亲无结核接触史。尽管缺乏母亲目前感染结核病的证据，但婴儿很可能患有先天性结核病。