Congenital tuberculosis: a review article

Abstract

TB remains a leading cause of morbidity and mortality in developing countries. The incidence of congenital TB is underestimated. Current recommendations regarding the management of neonates of mothers with tuberculosis are variable and no tangible guidelines have been advised. Congenital TB is fatal if untreated, moreover the mortality and morbidity is increased if the diagnosis and treatment is delayed. Therefore, the treating clinician should be aware of the unusual presentation of congenital TB. A high suspicion and good screening of mothers and neonates is of paramount importance. Congenital tuberculosis is diagnosed by Cantwell criteria. Isoniazid prophylaxis for 6 months is recommended in neonates born to mothers with TB who are infectious. Breastfeeding should be continued, and isolation is recommended only in certain circumstances such as mother is infectious, has multidrug resistant tuberculosis or non-adherent to treatment. BCG vaccine is recommended in all neonates however, the timing of administration varies according to various guidelines. Neonate diagnosed with congenital TB should be treated with anti-tubercular drug regimen.