Volume 82, Issue 11 (February 2025)
Tehran Univ Med J 2025, 82(11): 876-880 |
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Khodabandeh M, Abdolsalehi M, Gorji M. Congenital tuberculosis in a two-month-old infant presenting with respiratory distress: a case report. Tehran Univ Med J 2025; 82 (11) :876-880
URL: http://tumj.tums.ac.ir/article-1-13411-en.html
URL: http://tumj.tums.ac.ir/article-1-13411-en.html
1- Department of Infectious Diseases, Pediatric's Center of Excellence, Children's Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Cardiology, Pediatric's Center of Excellence, Children's Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Cardiology, Pediatric's Center of Excellence, Children's Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Abstract: (1269 Views)
Background: Congenital tuberculosis is a rare but serious disease in neonates and infants that often presents with nonspecific respiratory symptoms. Pulmonary involvement in tuberculosis can have similar manifestations to bacterial pneumonia with common microorganisms. In case of failure to respond to treatment in pneumonia, tuberculosis infection should be considered. The aim of this study was to present a two-month-old infant suspected of bacterial pneumonia, who was ultimately diagnosed with tuberculosis.
Case Presentation: This case report describes a two-month-old infant diagnosed with tuberculosis who presented to the emergency department with severe respiratory distress. Despite repeated hospitalizations and initial antibiotic therapy, the patient's symptoms did not improve and he was eventually referred to the Children's Medical Center. Chest radiography showed diffuse reticular opacities, alveolar opacities in the lower lobe of the right lung, and parahilar opacities in the left lung. Initial laboratory tests included elevated CRP and ESR levels, elevated white blood cell count, thrombocytosis, and abnormal arterial blood gases. Despite three negative gastric aspirate samples for tuberculosis, bronchoscopy was performed and a Bronchoalveolar Lavage (BAL) sample was sent for Polymerase Chain Reaction (PCR) testing for Mycobacterium tuberculosis, which was positive, confirming the diagnosis of tuberculosis. Careful evaluation of the parents revealed that although they had no respiratory symptoms, the mother had imaging evidence of tuberculosis, and her AFB test was positive. The patient showed significant clinical improvement after starting anti-tuberculosis therapy. A six-month follow-up confirmed complete recovery.
Conclusion: In infants with recurrent pneumonia and failure to respond to initial treatments, tuberculosis should be considered as a possible diagnosis.
Case Presentation: This case report describes a two-month-old infant diagnosed with tuberculosis who presented to the emergency department with severe respiratory distress. Despite repeated hospitalizations and initial antibiotic therapy, the patient's symptoms did not improve and he was eventually referred to the Children's Medical Center. Chest radiography showed diffuse reticular opacities, alveolar opacities in the lower lobe of the right lung, and parahilar opacities in the left lung. Initial laboratory tests included elevated CRP and ESR levels, elevated white blood cell count, thrombocytosis, and abnormal arterial blood gases. Despite three negative gastric aspirate samples for tuberculosis, bronchoscopy was performed and a Bronchoalveolar Lavage (BAL) sample was sent for Polymerase Chain Reaction (PCR) testing for Mycobacterium tuberculosis, which was positive, confirming the diagnosis of tuberculosis. Careful evaluation of the parents revealed that although they had no respiratory symptoms, the mother had imaging evidence of tuberculosis, and her AFB test was positive. The patient showed significant clinical improvement after starting anti-tuberculosis therapy. A six-month follow-up confirmed complete recovery.
Conclusion: In infants with recurrent pneumonia and failure to respond to initial treatments, tuberculosis should be considered as a possible diagnosis.
Keywords: bronchoscopy, congenital tuberculosis, infant, mycobacterium tuberculosis, respiratory distress.
Type of Study: Case Report |
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