Department of Pediatrics, Pediatric Pulmonology, Cystic Fibrosis Clinic and Pediatric Infectious Diseases, Universitair Ziekenhuis Brussel UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Eur J Pediatr. 2010 Sep;169(9):1155-8. doi: 10.1007/s00431-010-1177-8. Epub 2010 Apr 22.
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.
在结核病发病率较低的国家，围产期结核病很少被诊断出来。随着越来越多的艾滋病毒感染者和来自结核病高发国家的移民人口增加，人们可能会预期围产期结核病会变得更加频繁。早期识别有围产期结核病感染风险的新生儿对于通过化学预防来预防疾病至关重要。我们描述了一例由患有肺外原发性结核病的母亲感染的新生儿潜伏性围产期结核病感染。结核菌素皮肤试验呈阴性，最终通过特异性免疫试验诊断为潜伏性结核病感染。我们讨论了新生儿和婴儿近期结核病感染诊断的困难，以及结核病垂直传播的危险因素，在考虑是否需要对新生儿进行化学预防时需要考虑这些因素。虽然围产期 TB 感染是一种罕见的情况，由于妊娠和新生儿的诊断检测不佳，诊断困难，但需要高度怀疑，以限制诊断延迟，并避免进展为围产期 TB 疾病。
