Congenital Tuberculosis in a 2-Week-Old Neonate With an Asymptomatic Mother.
Sureka Pavalagantharajah, Syed Usman Ahmed, Brian Hummel et al.
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Case in brief
A 2-week-old male neonate presented with poor feeding and low-grade fever. Initial cultures and viral PCRs were negative, but worsening symptoms led to hospitalization. He developed respiratory failure requiring intubation, and congenital tuberculosis was confirmed via endotracheal aspirates. Treatment was initiated, but he experienced a paradoxical reaction necessitating corticosteroids. His asymptomatic mother was later diagnosed with genitourinary TB, and his twin brother also developed congenital TB.
What made this case unusual
The case highlights the occurrence of congenital tuberculosis in a neonate born to an asymptomatic mother, with a twin sibling also affected, which is atypical and underscores the need for vigilance in similar cases.
Diagnostic / clinical pearl
Clinicians should maintain a high index of suspicion for congenital tuberculosis in neonates, especially when maternal TB is suspected, even if the mother appears asymptomatic.
Why it matters
This case emphasizes the potential for perinatal transmission of tuberculosis and the importance of early diagnosis in at-risk populations to prevent severe outcomes.