Advertisement

Tuberculosis in the Neonate

  • Gabriella S. Lamb
  • Jeffery R. Starke
Chapter

Abstract

Tuberculosis (TB) is the most common infectious disease in the world, with more than one million new cases and 210,000 deaths in children annually (Murray et al., Lancet 384, 1005–70, 2014). Over two billion people are infected with Mycobacterium tuberculosis, and rates of TB disease are increasing among women of child-bearing age in developing countries (Hageman, J Perinatol. 18, 389–94, 1998; Margono et al. Obstet Gynecol. 83, 911–4, 1994; Starke, Clin Perinatol. 24, 107–27, 1997). Although TB infection and disease are very common, perinatally acquired infection and disease are rare and incompletely understood (Peker et al. Tuberk Toraks. 58, 93–6, 2010). Perinatally transmitted TB can be acquired vertically during the intrauterine period (congenital TB) or shortly after birth (postnatal) through exposure to someone with contagious pulmonary disease (Starke, Clin Perinatol. 24, 107–27, 1997; Malhamé et al. PLoS One 11, e0154825, 2016). Differentiating congenital and postnatally acquired TB is only important from an epidemiological standpoint as their clinical presentations, management, and prognosis are indistinguishable (Singh, J Trop Pediatr. 53, 135–8, 2007). Distinguishing TB infection from disease is important in determining management. If a person has a positive tuberculin skin test (TST) or interferon-gamma release assay (IGRA) with a normal CXR and is asymptomatic, he/she is considered to have TB infection. A person who has a positive TST or IGRA with an abnormal CXR or symptoms consistent with TB such as fever, cough, or weight loss is considered to have TB disease.

Keywords

Airborne Interferon gamma release assay Tuberculin skin test Tuberculosis 

References

  1. 1.
    Murray CJ, Ortblad KF, Guinovart C, et al. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990--2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:1005–70.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Hageman JR. Congenital and perinatal tuberculosis: discussion of difficult issues in diagnosis and management. J Perinatol. 1998;18:389–94.PubMedGoogle Scholar
  3. 3.
    Margono F, Mroueh J, Garely A, White D, Duerr A, Minkoff HL. Resurgence of active tuberculosis among pregnant women. Obstet Gynecol. 1994;83:911–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Starke JR. Tuberculosis. An old disease but a new threat to the mother, fetus, and neonate. Clin Perinatol. 1997;24:107–27.CrossRefPubMedGoogle Scholar
  5. 5.
    Peker E, Bozdoğan E, Doğan M. A rare tuberculosis form: congenital tuberculosis. Tuberk Toraks. 2010;58:93–6.PubMedGoogle Scholar
  6. 6.
    Malhamé I, Cormier M, Sugarman J, Schwartzman K. Latent Tuberculosis in Pregnancy: A Systematic Review. PLoS One. 2016;11:e0154825.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Singh M, Kothur K, Dayal D, Kusuma S. Perinatal tuberculosis a case series. J Trop Pediatr. 2007;53:135–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Saramba MI, Zhao D. A perspective of the diagnosis and management of congenital tuberculosis. J Pathog. 2016;2016:8623825.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Peng W, Yang J, Liu E. Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009. Pediatr Pulmonol. 2011;46:1215–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Ormerod P. Tuberculosis in pregnancy and the puerperium. Thorax. 2001;56:494–9.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Espiritu N, Aguirre L, Jave O, Sanchez L, Kirwan DE, Gilman RH. Congenital transmission of multidrug-resistant tuberculosis. Am J Trop Med Hyg. 2014;91:92–5.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Sagar T, Gupta K, Rani M, Kaur IR. Disseminated tuberculosis in a newborn infant. J Family Med Prim Care. 2016;5:695.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Khorsand Zak H, Mafinezhad S, Haghbin A. Congenital tuberculosis: a newborn case report with rare manifestation. Iran Red Crescent Med J. 2016;18:e23572.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Mittal H, Das S, Faridi MM. Management of newborn infant born to mother suffering from tuberculosis: current recommendations & gaps in knowledge. Indian J Med Res. 2014;140:32–9.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Cantwell MF, Shehab ZM, Costello AM, et al. Brief report: congenital tuberculosis. N Engl J Med. 1994;330:1051–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Vallejo JG, Starke JR. Tuberculosis and pregnancy. Clin Chest Med. 1992;13:693–707.PubMedGoogle Scholar
  17. 17.
    Hageman J, Shulman S, Schreiber M, Luck S, Yogev R. Congenital tuberculosis: critical reappraisal of clinical findings and diagnostic procedures. Pediatrics. 1980;66:980–4.PubMedGoogle Scholar
  18. 18.
    Hatzistamatiou Z, Kaleyias J, Ikonomidou U, Papathoma E, Prifti E, Kostalos C. Congenital tuberculous lymphadenitis in a preterm infant in Greece. Acta Paediatr. 2003;92:392–4.CrossRefPubMedGoogle Scholar
  19. 19.
    Ng PC, Hiu J, Fok TF, Nelson EAS, Cheung KL, Wong W. Isolated congenital tuberculosis otitis in a preterm infant. Acta Paediatr. 1995;84:955–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Aelami MH, Qhodsi Rad MA, Sasan MS, Ghazvini K. Congenital tuberculosis presenting as ascites. Arch Iran Med. 2011;14:209–10.PubMedGoogle Scholar
  21. 21.
    Vadivelu S, Effendi S, Starke JR, Luerssen TG, Jea A. A review of the neurological and neurosurgical implications of tuberculosis in children. Clin Pediatr. 2013;52:1135–43.CrossRefGoogle Scholar
  22. 22.
    Raj P, Sarin YK. Congenital tuberculosis in a neonate: a diagnostic dilemma. J Neonatal Surg. 2014;3:49.Google Scholar
  23. 23.
    Berk DR, Sylvester KG. Congenital tuberculosis presenting as progressive liver dysfunction. Pediatr Infect Dis J. 2004;23:78–80.CrossRefPubMedGoogle Scholar
  24. 24.
    Pejham S, Altman R, Li KI, Munoz JL. Congenital tuberculosis with facial nerve palsy. Pediatr Infect Dis J. 2002;21:1085–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Kumar A, Ghosh SB, Varshney MK, Trikha V, Khan SA. Congenital spinal tuberculosis associated with asymptomatic endometrial tuberculosis: a rare case report. Joint Bone Spine. 2008;75:353–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Smith KC. Congenital tuberculosis: a rare manifestation of a common infection. Curr Opin Infect Dis. 2002;15:269–74.CrossRefPubMedGoogle Scholar
  27. 27.
    Stahelin-Massik J, Carrel T, Duppenthaler A, Zeilinger G, Gnehm HE. Congenital tuberculosis in a premature infant. Swiss Med Wkly. 2002;132:598.PubMedGoogle Scholar
  28. 28.
    Whittaker E, Kampmann B. Perinatal tuberculosis: new challenges in the diagnosis and treatment of tuberculosis in infants and the newborn. Early Hum Dev. 2008;84:795–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Miller F. Tuberculosis in children. Evolution-control-treatment. Harcourt-Brace: San Diego; 1963.Google Scholar
  30. 30.
    Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009;9:737–46.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Kwan CK, Ernst JD. HIV and tuberculosis: a deadly human syndemic. Clin Microbiol Rev. 2011;24:351–76.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Beitzke H. Über die angeborene tuberkulöse Infektion. Ergeb Ges Tuberk Forsch. 1935;7:1–30.Google Scholar
  33. 33.
    Al-Zamel FA. Detection and diagnosis of Mycobacterium tuberculosis. Expert Rev Anti Infect Ther. 2009;7:1099–108.CrossRefPubMedGoogle Scholar
  34. 34.
    Dunn JJ, Starke JR, Revell PA. Laboratory diagnosis of Mycobacterium tuberculosis infection and disease in children. J Clin Microbiol. 2016;54:1434–41.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Denkinger CM, Schumacher SG, Boehme CC, Dendukuri N, Pai M, Steingart KR. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2014;44:435–46.CrossRefPubMedGoogle Scholar
  36. 36.
    Xpert MTB/RIF implementation manual: technical and operational ‘how-to’; practical considerations. Geneva: World Health Organization; 2014.Google Scholar
  37. 37.
    Ray M, Dixit A, Vaipei K, Singhi PD. Congenital tuberculosis. Indian Pediatr. 2002;39:1167–8.PubMedGoogle Scholar
  38. 38.
    Hanekom W. Tuberculosis. In: Remington and Klein’s infectious diseases of the fetus and newborn infant. 8th ed. Philadelphia: Elsevier; 2016.Google Scholar
  39. 39.
    Mlotha R, Waterhouse D, Dzinjalamala F, et al. Pharmacokinetics of anti-TB drugs in Malawian children: reconsidering the role of ethambutol. J Antimicrob Chemother. 2015;70:1798–803.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Patel S, DeSantis ERH. Treatment of congenital tuberculosis. Am J Health Syst Pharm. 2008;65:2027–31.CrossRefPubMedGoogle Scholar
  41. 41.
    Skevaki CL, Kafetzis DA. Tuberculosis in neonates and infants: epidemiology, pathogenesis, clinical manifestations, diagnosis, and management issues. Paediatr Drugs. 2005;7:219–34.CrossRefPubMedGoogle Scholar
  42. 42.
    Ghosh K, Chowdhury JR. Tuberculosis and female reproductive health. J Postgrad Med. 2011;57:307.CrossRefPubMedGoogle Scholar
  43. 43.
    Red Book. Report of the Committee on Infectious Diseases, Elk grove Village: American Academy of Pediatrics; 2015.Google Scholar
  44. 44.
    Lamounier JA, Moulin ZS, Xavier CC. Recommendations for breastfeeding during maternal infections. J Pediatr (Rio J). 2004;80:s181–8.CrossRefGoogle Scholar
  45. 45.
    Centers for Disease Control and Prevention. The role of BCG vaccine in the prevention and control of tuberculosis in the United States-a joint statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices. Morb Mortal Wkly Rep. 1996;45:1–27.Google Scholar
  46. 46.
    Abubakar I, Pimpin L, Ariti C, et al. Systematic review and meta-analysis of the current evidence on the duration of protection by bacillus Calmette-Guérin vaccination against tuberculosis. Health Technol Assess. 2013;17:1.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Roy A, Eisenhut M, Harris RJ, et al. Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis. BMJ. 2014;349:4643.CrossRefGoogle Scholar
  48. 48.
    Geiter LJ, Huebner RE, Lanner AH, Villarino ME. The role of BCG vaccine in the prevention and control of tuberculosis in the United States; a joint statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices; 1995.Google Scholar
  49. 49.
    Grisaru-Soen G, Savyon M, Sadot E, et al. Congenital tuberculosis and management of exposure in neonatal and pediatric intensive care units. Int J Tuberc Lung Dis. 2014;18:1062–5.CrossRefPubMedGoogle Scholar
  50. 50.
    Laartz BW, Narvarte HJ, Holt D, Larkin JA, Pomputius WF. Congenital tuberculosis and management of exposures in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2002;23:573–9.CrossRefPubMedGoogle Scholar
  51. 51.
    Crockett M, King SM, Kitai I, et al. Nosocomial transmission of congenital tuberculosis in a neonatal intensive care unit. Clin Infect Dis. 2004;39:1719–23.CrossRefPubMedGoogle Scholar
  52. 52.
    Lee LH, LeVea CM, Graman PS. Congenital tuberculosis in a neonatal intensive care unit: case report, epidemiological investigation, and management of exposures. Clin Infect Dis. 1998;27:474–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Winters A, Agerton TB, Driver CR, Trieu L, O’Flaherty T, Munsiff SS. Congenital tuberculosis and management of exposure in three neonatal intensive care units. Int J Tuberc Lung Dis. 2010;14:1641–3.PubMedGoogle Scholar
  54. 54.
    Reynolds DL, Gillis F, Kitai I, Deamond SL, Silverman M, King SM, et al. Transmission of Mycobacterium tuberculosis from an infant. Int J Tuberc Lung Dis. 2006;10:1051–6.PubMedGoogle Scholar
  55. 55.
    Jensen PA, Lambert LA, Iademarco MF, Ridzon R. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005;54:1–141.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Pediatric Infectious Diseases, Department of PediatricsBaylor College of MedicineHoustonUSA

Personalised recommendations