nal symptoms. His mother had cough for four months in
pregnancy which subsided before delivery. She received
unknown medications bought over the counter as she did
not have any antenatal care.15Other authors in Northern
The index patient fortunately, even with late presenta-
tion and diagnosis, showed a good response to a combi-
nation of three anti-tuber3culous drugs; isoniazid, rifam-
picin and pyrazinamide. There are other case reports in
Nigeria and South Florida also reported paucity of
t2h3.e literature of successful treatment of congenital TB
maternal symptoms. In a review by Abughali et al,
twenty four of thirty two mothers of infants diagnosed
with congenital TB were asymptomatic. The lack of
antenatal diagnosis in the mother of the index patient
highlights the need for early detection of the disease
during pregnancy with institution1,o9f appropriate therapy
to prevent infection of the foetus.
have shown that complications of
Congenital tuberculosis, though rare, should be consid-
ered in an infant diagnosed with pneumonia that is resis-
tant to antibiotic therapy especially in areas of high tu-
berculosis prevalence. Also there is need for anti tuber-
culosis therapeutic trial to be initiated as diagnostic tool
in resource limited settings where diagnosis could easily
be missed. A high index of suspicion is required towards
diagnosis of tuberculosis in pregnancy. Screening for
tuberculosis should be part of the routine prenatal care at
the slightest suspicion of tuberculosis.
late diagnosis of congenital TB include meningitis, mili-
tary TB and otitis media, resulting in seizures, deafness,
and death. It is therefore not surprising that the index
case who presented at tw8elve weeks of age, had miliary
tuberculosis. Peng et al reviewed imaging findings in
43 cases of congenital tuberculosis and 46.8% of them
demonstrated a miliary pattern. Similarly, Hagemann
showed that 50% of infants with congenital TB pre-
sented with miliary pattern of pulmonary involvement.
Congenital TB if left untreated or if treatment is com-
menced late, may have a fatal outcome as were the ca13ses
Conflict of interest: none
presented by Lee et al, Chen et al, and Ray et al. It
is recommended that treatment regimens for congenital
TB should contain at least two or preferably three 9d,2r0ugs
to which the organisms are likely to be susceptible.
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Larkin JA, Pomputius WF. Con-
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1946 and 2009. Paediatric Pul-
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