Clinical characteristics and post-discharge follow-up analyses of 10 infants with congenital tuberculosis: A retrospective observational study

Abstract

Importance: Congenital tuberculosis (TB) is a rare, potentially fatal disease. There is currently a lack of detailed clinical information available regarding this disease. Objective: This retrospective study investigated the clinical manifestations, treatment, and long-term prognosis of congenital TB. Methods: Patients were treated in Beijing Children’s Hospital, Capital Medical University (Beijing, China) between 2009 and 2018. Their demographic data, maternal and family histories, symptoms and signs, treatment information, and follow-up data were retrospectively collected using the hospital’s electronic information system. Results: Ten infants with congenital TB were enrolled. The mean gestational age was 36.6 ± 2.2 weeks and mean birth weight was 2517 ± 487 g. All 10 patients exhibited fever, nine patients (90%) had anemia, and six patients (60%) had extrauterine growth retardation. On chest computed tomography scans, all 10 patients presented multiple pulmonary nodules and four patients (40%) had mediastinal adenopathy. Nine out of ten (90%) completed the T-spot test, and eight of them (8/9, 89%) were positive. Anti-TB treatment was initiated upon diagnostic confirmation. All patients (100%) received combined treatment with isoniazid (INH) and rifampicin (RIF). Eight of 10 patients (80%) received combined treatment with INH, RIF, and pyrazinamide. The survival rate was 100%. One patient was lost to follow-up and four patients are currently continuing treatment. Three of nine patients (33%) achieved normal developmental milestones at 6 months of age. Interpretation: Early diagnosis based on maternal history, typical imaging results, and timely treatment can improve outcomes in infants with congenital TB.