关键词: 结核, 妊娠并发症, 感染性, 胎儿疾病, 婴儿, 疾病特征

Abstract:

Objective This study aimed to analyze the clinical characteristics of infants with congenital tuberculosis, and investigate the diagnosis and therapeutic schedule of congenital tuberculosis combined with the literature. Methods The data of 19 infants under the age of 6 months with congenital tuberculosis who were hospitalized in the Tuberculosis Department of Shanghai Public Health Clinical Center from January 2012 to September 2019 were collected, including age of onset, clinical manifestations, imaging and laboratory examination data, treatment and outcome, and then summarized combined with literature review. Results Among the 19 infants with congenital tuberculosis, there were 10 male (52.6%) and 9 female (47.4%), with the age of 3-60 days and the median age of 53 (30, 60) days; the shortest time of onset was 1 day after birth, and the longest was 45 days after birth, with the average onset time of (19.3±13.1) days. There were 10 cases (52.6%) with acute hematogenous disseminated tuberculosis, and 9 cases (47.4%) with primary tuberculosis; 9 cases (47.4%) had fever, and 8 cases (42.1%) had dyspnea and cyanosis. T-SPOT.TB test was positive in 9 cases (47.4%), and acid-fast staining smear and culture were positive in 6 cases (31.6%); GeneXpert MTB/RIF was performed in 17 cases, and 7 cases (41.2%) showed positive results. The chest CT imaging manifestations revealed 10 cases (52.6%) with diffuse miliary shadow of both lungs, 8 cases (42.1%) with local patchy shadow and enlargement of hilar lymph node, and 1 case (5.3%) with multiple patchy shadows of both lungs and pleural effusion; skull CT scanning showed 1 case (5.3%) with brain effusion; and gallbladder and spleen ultrasound examination showed hepatosplenomegaly in 9 cases (47.4%). All the infants received anti-tuberculosis treatment, and 17 cases recovered, 2 cases died. Conclusion The onset time of infants with congenital tuberculosis is usually within 2-4 weeks, the disease develops rapidly and critically, with a high mortality. Early positive anti-tuberculosis treatment plays a decisive role in the prognosis of infant with congenital tuberculosis.

Key words: Tuberculosis, Pregnancy complications, Infectious, Fetal diseases, Infant, Disease characteristics