Connatal tuberculosis in a very premature infant.
Connatal tuberculosis is increasing in incidence and the mortality and morbidity of this disease remains high. We report a 27-week-old, 896 g female premature infant who had mild respiratory distress syndrome after birth. She developed signs of infection, progressive pneumonia and atelectasis which did not respond to mechanical ventilation and antibiotics. At 41 days of age, Mycobacterium tuberculosis was isolated from the non-bronchoscopic bronchoalveolar lavage. The isolate was sensitive to isoniazid, rifampin, streptomycin, and pyrazinamide. Miliary tuberculosis was subsequently diagnosed in her mother on a chest X-ray film and sputum cultures. The infant was treated successfully with anti-tuberculosis drugs. She had normal growth and development at the chronological age of 20 months old.


CONCLUSIONS
Connatal tuberculosis should be considered in premature infants with symptoms of sepsis refractory to antibiotics. Most premature infants with connatal tuberculosis have lung involvement, and non-bronchoscopic bronchoalveolar lavage can be a useful procedure to establish the diagnosis.
Chang
Mei-Ling
ML
Division of Neonatology, Department of Paediatrics, Chang Gung Children's Hospital, 5 Fu Hsing Street, Kweishan 333 Taoyuan, Taiwan.
Jou
Shiann-Tarng
ST
Wang
Chao-Ran
CR
Chung
Ming-Tsung
MT
Lai
Shen-Hao
SH
Wong
Kin-Sun
KS
Huang
Yhu-Chering
YC
Chou
Yi-Hung
YH
D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011859:Radiography; D014391:Tuberculosis, Miliary / Q000151:congenital* / Q000000981:diagnostic imaging / Q000188:drug therapy
D000995:Antitubercular Agents