BACKGROUND:

Congenital tuberculosis is an exceptional bacterial infection caused by Mycobacterium tuberculosis. It is transmitted vertically from mother to fetus in 16% of cases. It can be by two routes: transplacental through the umbilical vein or by contamination of the amniotic fluid that can be aspirated or ingested by the fetus. Its diagnosis is challenging, with nonspecific symptoms. It is suspected in neonates born to mothers with tuberculosis; mortality is high.

CLINICAL CASE:

A 30-year-old patient with a history of mild intermittent asthma treated with salbutamol, two pregnancies, one delivery and one miscarriage and an ongoing gestation of 35 weeks at the Hospital Universitario de la Samaritana. She consulted due to fever associated with respiratory symptoms, with positive bacilloscopy. Pulmonary tuberculosis was diagnosed. During hospitalization she had preterm labor, with live newborn, which was isolated due to maternal diagnosis. Prophylactic treatment with isoniazid was indicated; congenital tuberculosis was diagnosed by positive PCR for Mycobacterium tuberculosis in gastric juice. Treatment was complemented with rifampicin, pyrazinamide and ethambutol, with which the clinical response was favorable.

CONCLUSION:

Congenital tuberculosis is a rare disease, with nonspecific symptoms. It may be suspected in the newborn child of a mother with this diagnosis or without response to traditional antibiotic treatment or supportive therapy in neonatal intensive care units. Diagnosis is based on microbiological detection of the bacillus. Early treatment is associated with better perinatal outcomes and decreased mortality.

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