Hoyos-Orrego Álvaro, Trujillo-Honeysberg Mónica, Diazgranados-Cuenca Lucy
Clínica Universitaria Bolivariana, Servicio de Pediatría, Universidad Pontificia Bolivariana, Medellin, Colombia. ; Universidad CES, Medellin, Colombia.
Clínica Universitaria Bolivariana, Servicio de Pediatría, Universidad Pontificia Bolivariana, Medellin, Colombia. ; Universidad CES, Medellin, Colombia. ; Hospital Pablo Tobón Uribe, Medellin, Colombia.
Tuberc Respir Dis (Seoul). 2015 Oct;78(4):450-4. doi: 10.4046/trd.2015.78.4.450. Epub 2015 Oct 1.
Although tuberculosis is highly prevalent worldwide, congenital tuberculosis is one of the least common manifestations of the disease. The diagnosis is usually difficult because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy and delivery. We present the case of a preterm neonate with congenital tuberculosis, born to a previously healthy mother who had developed severe disseminated tuberculosis during her pregnancy. Once the diagnosis was confirmed in the mother, the congenital infection was confirmed by isolation of Mycobacterium tuberculosis in gastric aspirates, and positive polymerase chain reaction in a cerebrospinal fluid examination. Treatment for tuberculosis with a four-drug regimen resulted in an adequate clinical response in both the mother and infant.
尽管结核病在全球范围内高度流行,但先天性结核病却是该疾病最不常见的表现之一。由于临床表现不具特异性,且在妊娠和分娩前对母体疾病缺乏认识,诊断通常很困难。我们报告一例先天性结核病的早产新生儿病例,其母亲此前健康,但在孕期发生了严重的播散性结核病。母亲确诊后,通过胃抽吸物中分离出结核分枝杆菌以及脑脊液检查中聚合酶链反应呈阳性,证实了先天性感染。采用四联药物方案治疗结核病,使母亲和婴儿均获得了良好的临床反应。