Villemin P
Service de pédiatrie, Centre Hospitalier, Briançon, France.
Pediatrie. 1988;43(1):31-3.
A case of lethal acute congenital tuberculosis is reported in a 3-week-old infant who presented a crural adenopathy. An acute miliary pulmonary tuberculosis with extensive cutaneous reaction to tuberculin then appeared. Mycobacterium tuberculosis was found in the node and in urines. Specific treatment was ineffective and the child died within 5 weeks because of extensive lung lesions. A patent pulmonary tuberculosis was discovered in a grandmother that could not be incriminated to contamination because the incubation period was too short and the germ was of different type. A foetopathy could have been transmitted by the mother, who previously had a pulmonary tuberculosis, without late genital localisation. Therefore, a transient bacteriema from an enclosed older lung lesion in the mother may be evoked. A preventive treatment and a tight survey must be undertaken for a next pregnancy.
报道了一例3周龄婴儿的致死性急性先天性结核病病例，该婴儿出现了腹股沟淋巴结肿大。随后出现了急性粟粒性肺结核，并伴有对结核菌素的广泛皮肤反应。在淋巴结和尿液中发现了结核分枝杆菌。特异性治疗无效，患儿因广泛的肺部病变在5周内死亡。在患儿祖母身上发现了开放性肺结核，但由于潜伏期过短且病菌类型不同，不能认定为感染源。可能是患儿母亲传播了胎儿疾病，其母亲曾患肺结核，但未出现晚期生殖器局部病变。因此，可以推测母亲肺部陈旧性病灶出现了短暂菌血症。下一胎妊娠时必须进行预防性治疗并密切监测。
