MANIFESTACIONES CLÍNICAS Y EVOLUCIÓN DE TUBERCULOSIS CONGÉNITA:REPORTE DE CASO

• Autores: Gomez-Galiano, Walter David, Huaman-Benites, Zoila
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Instituto Nacional Materno Perinatal
• Repositorio: Revista Peruana de Investigación Materno Perinatal
• Lenguaje: español
• OAI Identifier: oai:investigacionmaternoperinatal.inmp.gob.pe:article/514
• Enlace del recurso: https://investigacionmaternoperinatal.inmp.gob.pe/index.php/rpinmp/article/view/514
• Nivel de acceso: acceso abierto
• Materia: Mycobacterium tuberculosis; Tuberculosis, Pulmonary; Premature Infant; Neonatal Intensive Care; Case Report; tuberculosis pulmonar; recién nacido prematuro; Cuidado Intensivo Neonatal; Informe de casos

A 31-week preterm male newborn weighing 1235 g was delivered to a 26-year-old mother who had been hospitalized due to a threat of preterm labour. During hospitalization, the mother developed fever and respiratory deterioration, and postpartum, she was diagnosed with pulmonary tuberculosis by Xpert MTB/RIF positive, with no resistance to rifampicin. The neonate presented with respiratory distress and was initially managed with bubble CPAP for prematurity or probable sepsis. On day three of life, prompted by the maternal history, Xpert MTB/RIF and acid-fast bacilli (AFB) tests were positive in gastric aspirate and stool, as well as Xpert MTB/RIF in cerebrospinal fluid (CSF), confirming systemic congenital tuberculosis with meningitis. A tetraconjugate regimen for sensitive tuberculosis (isoniazid, rifampin, pyrazinamide, and ethambutol) was started, along with prednisone and adjustments based on weight. During the course, the infant showed poor weight gain and steatorrhea due to gastrointestinal malabsorption, which improved with medium-chain triglycerides. The infant experienced progressive recovery and was discharged with a multidisciplinary follow-up plan.