Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (i): Epidemiology and diagnosis. Congenital tuberculosis

Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
F Baquero-ArtigaoGrupo de trabajo de tuberculosis gestacional, congénita y posnatal de la Sociedad Española de Infectología Pediátrica (SEIP)

Abstract

Tuberculosis (TB) screening in pregnancy using tuberculin skin test (TST) is recommended in case of symptoms of TB disease, close contact with a patient with infectious TB, or high risk of developing active disease. The new interferon gamma release assay (IGRA) tests are recommended in BCG-vaccinated pregnant women with positive TST and no known risk factors for TB, and in those immunocompromised, with clinical suspicion of TB but negative TST. TB diagnosis is difficult due to the non-specific symptoms, the increased frequency of extrapulmonary disease, the delay in radiological examinations, and the high rate of tuberculin anergy. Neonatal TB can be acquired in utero (congenital TB), or through airborne transmission after delivery (postnatal TB). Congenital TB is extremely rare and does not cause fetal malformations. It may be evident at birth, although it usually presents after the second week of life. In newborns with no family history of TB, the disease should be considered in cases of miliary pneumonia, hepatosplenomegaly with focal lesions, or lymphocytic meningitis with hypoglycorrhachia, especially in those born to immigrants from high TB-burden countries. TST is usually negative, and IGRAs have lower sensitivity than i...Continue Reading

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Citations

Apr 8, 2016·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·Ignacio Ruiz Del Olmo IzuzquizaCarmelo Guerrero Laleona
Dec 22, 2016·Journal of Pathogens·Manou Irmina Saramba, Dongchi Zhao
Oct 30, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Michal KouckyKhaled M Ismail

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