Department of Paediatrics, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
J Trop Pediatr. 2019 Apr 1;65(2):188-191. doi: 10.1093/tropej/fmy020.
Multidrug-resistant tuberculosis (MDR-TB) is a well-identified raising public health concern worldwide. However, the data available on MDR-TB in children and particularly in the neonate age group are limited. Congenital tuberculosis (TB) is rare, and its diagnosis is challenging because of non-specific manifestations. The choice of anti-tubercular drugs is difficult because of the lack of international consensus as a consequence of the scarcity of evidence-based data on this age group. We hereby present a case from Bhutan of a 23-day-old male neonate with congenital MDR-TB. His mother was diagnosed with disseminated TB, and treatment was commenced 11 days post-partum. Congenital transmission of TB was suspected, as direct postnatal transmission was unlikely and thorough screening of contacts for TB was negative. In this case, the mother's MDR-TB status was revealed only after her newborn's MDR-TB diagnosis.
耐多药结核病（MDR-TB）是一个广受关注的全球公共卫生问题。然而，关于儿童，特别是新生儿期耐多药结核病的数据有限。先天性结核病（TB）罕见，由于缺乏基于证据的数据，其诊断具有挑战性，因为临床表现不具有特异性。由于缺乏针对这一年龄组的循证数据，国际共识也难以达成，抗结核药物的选择困难。我们在此报告来自不丹的一例 23 天大的男性新生儿先天性耐多药结核病病例。他的母亲被诊断为播散性结核病，产后 11 天开始治疗。由于直接产后传播的可能性不大，且对 TB 接触者的全面筛查均为阴性，因此怀疑存在先天性 TB 传播。在这种情况下，只有在新生儿 MDR-TB 诊断后才发现母亲的 MDR-TB 状况。
