Congenital tuberculosis

Congenital tuberculosis is rare. Fetal infection in early pregnancy leads to spontaneous abortions and stillbirths. If pregnancy is continued, children are born prematurely, with signs of intrauterine hypotrophy, low body weight. In the first days after birth, the child may seem healthy. In the 2nd week, lethargy, drowsiness, dyspeptic disorders appear, symptoms of intoxication increase, hepatosplenic syndrome, enlarged peripheral lymph nodes, signs of respiratory failure (shortness of breath, cyanosis) are detected, auscultatory catarrhal changes appear in the lungs, percussion changes, jaundice, hemorrhagic syndrome may occur. Acute onset of the disease from birth is also possible (in the case of miliary dissemination) with a progressive deterioration of the general condition and the addition of neurological symptoms.

Diagnostic criteria for congenital tuberculosis:

• the presence of tuberculosis in the mother;
• results of a carefully collected anamnesis (previously noted mother's complaints of weakness, subfebrile temperature, prolonged bronchitis, acute respiratory viral infections during pregnancy, history of infertility, spontaneous abortions, inflammatory diseases of the genital organs, pyelonephritis).

In the absence of data on tuberculosis in the mother, differential diagnostics is difficult. The clinical picture is similar to many diseases (intrauterine infection, generalized mycoplasma infection, pneumocystosis, congenital syphilis, sepsis, pneumonia, HIV infection). If congenital tuberculosis is suspected, an X-ray examination is necessary not only of the child, but also of the mother.

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