Del Rosal Rabes Teresa, Baquero-Artigao Fernando, Méndez-Echevarría Ana María, Mellado Peña María José
Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales Pediátricas, Hospital Universitario La Paz, Madrid, España.
Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales Pediátricas, Hospital Universitario La Paz, Madrid, España.
Enferm Infecc Microbiol Clin. 2017 Apr;35(4):243-245. doi: 10.1016/j.eimc.2015.03.011. Epub 2015 Apr 30.
A review was conducted on infants less than 3 months of age diagnosed with tuberculosis between 1978 and 2014. Eight patients were diagnosed (1.4% of paediatric tuberculosis cases): 3 confirmed congenital tuberculosis, 3 suspected (endometrial biopsy was not performed), and 2 postnatal tuberculosis. Tuberculin skin test was negative in two patients. Diagnostic performance of culture (7/7, 100%) and PCR (3/3, 100%) of gastric aspirates was higher than that of acid-fast bacilli smears (5/8, 62%) and IGRA test (1/3, 33%). Three patients developed miliary disease, and one died. In conclusion, tuberculosis in this age group is rare, severe, and difficult to diagnose. In cases lacking known postnatal contacts, maternal genital tuberculosis should be ruled out by endometrial biopsy.
对1978年至2014年间诊断为结核病的3个月以下婴儿进行了一项回顾性研究。共诊断出8例患者（占儿童结核病病例的1.4%）：3例确诊为先天性结核病，3例疑似（未进行子宫内膜活检），2例为产后结核病。2例患者结核菌素皮肤试验呈阴性。胃抽吸物培养（7/7，100%）和PCR（3/3，100%）的诊断效能高于抗酸杆菌涂片（5/8，62%）和IGRA检测（1/3，33%）。3例患者发生粟粒性疾病，1例死亡。总之，该年龄组的结核病罕见、严重且难以诊断。在缺乏已知产后接触史的病例中，应通过子宫内膜活检排除母亲生殖器结核。
