Perinatal Tuberculosis Presenting as Miliary Tuberculosis and Meningitis

Heda Melinda D. Nataprawira, Faisal -

Abstract


Perinatal tuberculosis (TB) is rarely reported, because the clinical manifestations are not specific and there is aproblem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferreddescription that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3-month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unableto breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali werefound on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculinetest was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculousmeningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission.In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminatedintravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus wasidentified from blood culture. In conclusion, although there were no problems during labor, active investigation ofperinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessaryat developing country with high rates of TB. [MKB. 2010;42(3):135-9].

Key words: Disseminated intravascular coagulation, miliary, meningitis, perinatal tuberculosis


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