关键词: 结核, 妊娠并发症, 抗药性, 综述文献(主题)

Abstract:

Objective: To review the clinical characteristics, diagnosis and treatment of congenital tuberculosis combined with the literature, in order to accumulate clinical experience for clinicians. Methods: The clinical data of a child with congenital drug-resistant tuberculosis and its mother admitted to Xi’an Chest Hospital in October 2020 were retrospectively analyzed. Taking “congenital tuberculosis” as the keyword, the literature was searched through the CNKI, Wanfang, PubMed and CJFD, and a total of 24 related literatures were searched out, and 2 cases of them were drug-resistant tuberculosis. Combined with this case, the clinical characteristics, diagnosis and treatment of 17 congenital tuberculosis children whose mothers underwent in vitro fertilization-embryo transfer were analyzed, and the 17 children were selected from 11 literatures. Results: In this study, there were 18 children, including 2 pairs of twins; 12 children’mothers had a history of tuberculosis or close contact to tuberculosis, 4 cases had no history of tuberculosis or close contact to tuberculosis; 5 cases were screened for tuberculosis infection before pregnancy, and 11 cases without screening. Sixteen cases were screened for tuberculosis after ineffective anti-infective treatment of “neonatal pneumonia, sepsis, fever”, and the time from onset to diagnosis was 3-44 days. The clinical manifestation is fever, cough, dyspnea, hepatomegaly, jaundice, apnea, diarrhea, and ear pus. Chest CT showed diffuse miliary nodular shadow, mediastinal and hilar lymph node enlargement, and a small amount of pleural effusion. In this study, of the 15 cases treated with the first-line anti-tuberculosis regimen, 11 had good prognosis, and 4 cases were found to be critically ill and died. Three cases were congenital drug-resistant tuberculosis, one was found “rifampicin” drug resistance and one showed “isoniazid” drug resistance through gastric juice test, and the case in our hospital was founde “isoniazid, rifampicin, rifampicin, and Isoniazid Aminosalicylate” drug resistance. Three cases were given second-line anti-tuberculosis treatment, no obvious adverse drug reactions were found, and the prognosis was good. Conclusion: The clinical manifestations of congenital drug-resistant tuberculosis were not specific, but the clinical symptoms were more serious. The second-line anti tuberculosis drugs had less adverse reactions and were relatively safe.

Key words: Tuberculosis, Pregnancy complications, Drug resistance, Review literature as topic