Culture-Confirmed Tuberculosis in South African Infants Younger Than 3 Months of Age: Clinical Presentation and Management of Respiratory Complications

The Pediatric Infectious Disease Journal
Lisa FrigatiHendrik Simon Schaaf

Abstract

Little is known about the course and management of perinatal tuberculosis (TB). We describe the presentation, medical and surgical management of culture-confirmed TB in infants younger than 3 months of age. We conducted a retrospective study including all infants younger than 3 months of age with culture-confirmed TB admitted to Tygerberg Hospital, Cape Town, South Africa from March 2003 through June 2015. During the study period, 106 of 2017 (5%) children younger than 13 years of age with culture-confirmed TB were infants younger than 3 months of age. The median age on admission was 67 days (IQR 40-79). Intrathoracic TB was present in 101 (95%) infants; of these, 34 (32%) had extrathoracic TB (ETTB). Two (2%) infants had ETTB only, while 3 (3%) infants were asymptomatic and diagnosed as having TB infection only. Forty (38%) infants were HIV-exposed and 14 (13%) were HIV-infected. The mother was identified as the source case in 53 (50%) infants. Mycobacterium tuberculosis was cultured in a median of 2 (IQR 1-7) specimens per infant; 9 (9%) had drug-resistant TB. Bronchoscopy was done in 37 (35%) infants and 27 (26%) underwent intrathoracic lymph node decompression. Twelve (11%) infants died during admission, 81(76%) were clinic...Continue Reading

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