Congenital tuberculosis and management of exposure in neonatal and pediatric intensive care units

Galia Grisaru-Soen, M. Savyon, E. Sadot, V. Schechner, Y. Sivan, D. Schwartz, J. Tarabeia, Z. Amitai, I. Yoabov, Y. Carmeli

Research output: Contribution to journalArticlepeer-review

Abstract

SETTING: This report describes the management and outcome of neonatal intensive care unit (NICU) and paediatric ICU (PICU) exposure to a 26-day-old premature infant with congenital tuberculosis (TB). DESIGN: The infant's mother underwent chest X-ray (CXR) and sputum culture. Contacts of the infant were identified. Tuberculin skin tests (TSTs) were performed on 97 infants and children, 156 NICU and PICU visitors and 115 health care workers. RESULTS: The mother's sputum culture was positive for Mycobacterium tuberculosis. No TST conversion occurred in the exposed NICU infants. All neonates received prophylactic isoniazid (INH). One exposed child in the PICU had TSTconversion with normal CXR and completed 9 months of INH without developing active disease; 22 (14%) PICU and NICU visitors and 3 NICU personnel had TST conversion without evidence of disease. CONCLUSIONS: The sequence of events described here demonstrates the difficulty in diagnosis and management of TB in this age group. Transmission of TB in NICU and PICUs is unusual but can occur, and calls for a systematic approach to investigation of the exposed infants, family members and health care providers.

Original languageEnglish
Pages (from-to)1062-1065
Number of pages4
JournalInternational Journal of Tuberculosis and Lung Disease
Volume18
Issue number9
DOIs
StatePublished - 1 Sep 2014
Externally publishedYes

Keywords

  • Contact investigation
  • Infant
  • Tuberculosis

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