Lin Hu, Teng Shuang, Wang Zhong, Liu Qi-Yu
Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610036, Sichuan Province, China.
World J Clin Cases. 2022 Jun 6;10(16):5495-5501. doi: 10.12998/wjcc.v10.i16.5495.
Congenital tuberculosis (TB), tuberculous meningitis, and situs inversus totalis are rare diseases. We here report a patient who simultaneously suffered from these three rare diseases. There is currently no such report in the literature. Congenital TB is easily misdiagnosed and has a high case fatality rate. Timely anti-TB treatment is required.
A 19-day-old male newborn was admitted to hospital due to a fever for 6 h. His blood tests and chest X-rays suggested infection, and he was initially considered to have neonatal pneumonia and sepsis. He did not respond to conventional anti-infective treatment. Finally, was found in sputum lavage fluid on the 10 day after admission. In addition, the mother's tuberculin skin test was positive, with an induration of 22 mm, and her pelvic computed tomography scan suggested the possibility of tuberculous pelvic inflammatory disease. The child was diagnosed with congenital TB and immediately managed with anti-TB therapy and symptomatic supportive treatment. However, the infant's condition gradually worsened and he developed severe tuberculous pneumonia and tuberculous meningitis, and eventually died of respiratory failure.
If conventional anti-infective treatment is ineffective in neonatal pneumonia, anti-TB treatment should be considered.
先天性结核病、结核性脑膜炎和全内脏转位是罕见疾病。我们在此报告一名同时患有这三种罕见疾病的患者。目前文献中尚无此类报告。先天性结核病容易误诊且病死率高，需要及时进行抗结核治疗。
一名19日龄男婴因发热6小时入院。血液检查和胸部X光提示感染，最初考虑为新生儿肺炎和败血症。他对常规抗感染治疗无反应。入院第10天，痰灌洗液中发现[此处原文缺失关键信息]。此外，母亲结核菌素皮肤试验呈阳性，硬结直径22毫米，盆腔计算机断层扫描提示可能患有结核性盆腔炎。该患儿被诊断为先天性结核病，并立即接受抗结核治疗和对症支持治疗。然而，婴儿病情逐渐恶化，发展为重症结核性肺炎和结核性脑膜炎，最终死于呼吸衰竭。
如果新生儿肺炎常规抗感染治疗无效，应考虑抗结核治疗。
