Congenital Tuberculosis in a Two-Month-Old Infant Presenting With Respiratory Distress: A Case Report; [سل مادرزادی در شیرخوار دو ماهه مراجعه با دیسترس تنفسی: گزارش یک مورد نادر]



Khodabandeh M ; Abdolsalehi M ; Gorji M
Source: Tehran University Medical Journal Published:2025

Abstract

Background: Congenital tuberculosis is a rare but serious disease in neonates and infants that often presents with nonspecific respiratory symptoms. Pulmonary involvement in tuberculosis can have similar manifestations to bacterial pneumonia with common microorganisms. In case of failure to respond to treatment in pneumonia, tuberculosis infection should be considered. The aim of this study was to present a twomonth-old infant suspected of bacterial pneumonia, who was ultimately diagnosed with tuberculosis. Case Presentation: This case report describes a two-month-old infant diagnosed with tuberculosis who presented to the emergency department with severe respiratory distress. Despite repeated hospitalizations and initial antibiotic therapy, the patient’s symptoms did not improve and he was eventually referred to the Children’s Medical Center. Chest radiography showed diffuse reticular opacities, alveolar opacities in the lower lobe of the right lung, and parahilar opacities in the left lung. Initial laboratory tests included elevated CRP and ESR levels, elevated white blood cell count, thrombocytosis, and abnormal arterial blood gases. Despite three negative gastric aspirate samples for tuberculosis, bronchoscopy was performed and a Bronchoalveolar Lavage (BAL) sample was sent for Polymerase Chain Reaction (PCR) testing for Mycobacterium tuberculosis, which was positive, confirming the diagnosis of tuberculosis. Careful evaluation of the parents revealed that although they had no respiratory symptoms, the mother had imaging evidence of tuberculosis, and her AFB test was positive. The patient showed significant clinical improvement after starting anti-tuberculosis therapy. A six-month follow-up confirmed complete recovery. Conclusion: In infants with recurrent pneumonia and failure to respond to initial treatments, tuberculosis should be considered as a possible diagnosis. Copyright © 2025 Khodabandeh. et al. Published by Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-Non-Commercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of thework are permitted, provided the original work is properly cited.