P37.0

Clinical Causes: Transmission of Mycobacterium tuberculosis bacteria from mother to fetus during pregnancy through the placenta. Infection of the baby during childbirth, especially if the mother has active tuberculosis in the genital tract. Postnatal transmission, although less common, can occur through inhalation of airborne bacteria from an infectious caregiver or family member. Maternal history of untreated or inadequately treated tuberculosis increases the likelihood of congenital infection.

Key Symptoms: Fever, often persistent or recurrent. Poor weight gain and failure to thrive. Lethargy and irritability. Respiratory difficulties such as cough or rapid breathing. Hepatosplenomegaly (enlargement of the liver and spleen). Lymphadenopathy (swollen lymph nodes). Skin lesions, such as rashes or areas of inflammation. Signs of systemic infection, including vomiting or diarrhea in some cases. Jaundice or other signs indicating liver involvement.

Diagnosis Path: Detailed maternal history, including any history of tuberculosis or exposure. Physical examination of the infant for signs of infection or organ involvement. Laboratory tests such as acid-fast bacilli (AFB) smear from gastric aspirates, cerebrospinal fluid, or biopsies. Polymerase chain reaction (PCR) testing for rapid detection of tuberculosis DNA. Mantoux tuberculin skin test or interferon-gamma release assays (IGRAs) can support diagnosis but are less definitive in neonates. Imaging studies like chest X-ray to identify pulmonary involvement or miliary patterns. Biopsy of affected tissues if necessary, to confirm presence of tuberculosis bacteria.

Treatment Protocols: First-line anti-tubercular medications such as isoniazid, rifampicin, ethambutol, and pyrazinamide. Monitoring for drug side effects, especially liver function and visual acuity. Supportive care like nutritional support and management of complications. In some cases, corticosteroids may be used to reduce inflammation or manage CNS involvement. Close follow-up to assess treatment response and adverse effects. Infection control measures to prevent transmission within healthcare settings and at home.