title: Latent tuberculosis in a newborn: diagnostic challenges.
abstract: In countries where the incidence of tuberculosis is low, perinatal tuberculosis is seldom diagnosed. With increasing numbers of human immunodeficiency virus-infected people and increasing immigrant population from high tuberculosis incidence countries, one might expect perinatal tuberculosis to become more frequent. Early recognition of newborns at risk for perinatal tuberculosis infection is of utmost importance to prevent disease by chemoprophylaxis. We describe a case of latent perinatal tuberculosis infection in a newborn infected from a mother with extrapulmonary primary tuberculosis. Tuberculin skin test was negative, and latent tuberculosis infection was eventually diagnosed by specific immunological tests. We discuss the difficulties in diagnosis of recent tuberculosis infection in neonates and infants, and the risk factors for vertical transmission of tuberculosis, which need to be taken into account in considering the need for chemoprophylaxis in the newborn. Although perinatal TB infection is a rare condition and diagnosis is difficult due to poor diagnostic testing in pregnancy and newborns, a high index of suspicion is needed to limit the diagnostic delay and to avoid progression to perinatal TB disease.
authors.affiliation: Department of Pediatrics, Pediatric Pulmonology, Cystic Fibrosis Clinic and Pediatric Infectious Diseases, Universitair Ziekenhuis Brussel UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. iris.deschutter@uzbrussel.be
authors.forename: Iris
authors.initials: I
authors.lastname: De Schutter
authors.forename: Kinda
authors.initials: K
authors.lastname: Schepers
authors.forename: Mahavir
authors.initials: M
authors.lastname: Singh
authors.forename: Françoise
authors.initials: F
authors.lastname: Mascart
authors.forename: Anne
authors.initials: A
authors.lastname: Malfroot
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission*; D011247:Pregnancy; D014374:Tuberculin Test; D014396:Tuberculosis, Pleural / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents
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