Congenital Tuberculosis: Report of a Case

Abstract

This report describes an infant with congenital tuberculosis. The rarity of congenital acquisition of tuberculosis makes this case unusual. The infant presented with a problem of pulmonary infiltrates unresponsive to antibiotics. Only after the patient died at 8 weeks of age was the diagnosis confirmed by isolation of M. tuberculosis. The mother was febrile at delivery and in the postpartum period. She had a negative PPD skin test reaction and chest x-ray after delivery but left the hospital before the etiology of her febrile illness was determined. She died 3½ months after delivery despite eight weeks of chemotherapy for tuberculosis. Postmortem examination of the mother revealed miliary tuberculosis with marked involvement of the pelvic organs. Progressive primary tuberculous infection of the mother appears likely. The mode of fetal infection could not be determined, but hematogenous transmission via the umbilical vein or through fetal aspiration of infected amniotic fluid is likely.