Paediatrics and International Child Health最新文献

{"title":"A gastric outlet thickened mucosal fold associated with cytomegalovirus infection in an extremely preterm infant managed by surgical resection.","authors":"Susmitha Tangirala,&nbsp;Prakash Amboiram,&nbsp;Umamaheswari Balakrishnan,&nbsp;Sandhya Sundaram,&nbsp;Prakash Agarwal,&nbsp;Usha Devi","doi":"10.1080/20469047.2021.1967626","DOIUrl":"https://doi.org/10.1080/20469047.2021.1967626","url":null,"abstract":"<p><p>Non-bilious vomiting in preterm neonates discharged from neonatal intensive care units is a common complaint and is often associated with benign conditions such as gastro-oesophageal reflux. A neonate of 27 weeks gestation who presented later with vomiting owing to gastric outlet obstruction is described. He was discharged at 11 weeks of age and required re-admission 1 week later. He had persistent non-bilious vomiting from 7 weeks of age, failure to thrive and metabolic alkalosis. Clinical examination demonstrated visible gastric peristalsis, and hypertrophic pyloric stenosis was suspected. Ultrasound of the gastric pylorus and upper gastro-intestinal contrast studies were negative. Exploratory laparotomy after failure of conservative management revealed a thickened mucosal fold in the gastric pylorus, which was excised. Histopathology demonstrated inclusion bodies which are pathognomonic of cytomegalovirus infection. He was treated with valganciclovir for 6 weeks and was asymptomatic and thriving well at follow-up. Gastric outlet obstruction can be one of the manifestations of CMV infection of the gastro-intestinal tract. Diagnosis can be confirmed only by histopathology.<b>Abbreviations:</b> BPD: bronchopulmonary dysplasia; CMV: cytomegalovirus; H&E: haematoxylin and eosin; IHC: immunohistochemistry; IHPS: infantile hypertrophic pyloric stenosis; NEC: necrotising enterocolitis; PCR: polymerase-chain reaction; VGP: visible gastric peristalsis.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"41-44"},"PeriodicalIF":1.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39413772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study comparing short-term outcome in preterm infants of ≤30 weeks gestation between a tertiary neonatal care unit in Bangalore, India and one in London, UK","authors":"Shivashankar Diggikar, N. Nagesh, N. A. Kumar, N. Aladangady","doi":"10.1080/20469047.2022.2054916","DOIUrl":"https://doi.org/10.1080/20469047.2022.2054916","url":null,"abstract":"ABSTRACT Background Large numbers of preterm infants are born in middle-income countries and neonatal care is improving in these countries. Few studies have compared clinical outcome in preterm infants in a tertiary neonatal unit in a middle-income country with one in a high-income country. Objective To compare the short-term outcome in preterm infants of ≤30 weeks gestation admitted to a tertiary neonatal unit in Bengaluru, India and in London, UK. Methods This was a retrospective observational study using anonymised data from electronic patient records. Preterm infants born at ≤30 weeks gestation admitted to neonatal units in Bengaluru (n = 294) and London (n = 740) over a 5-year period (January 2011 to December 2015) were compared. Results Fewer mothers in the Bengaluru centre received antenatal steroids (37% vs 73%, p < 0.001). The incidence of retinopathy of prematurity requiring treatment (12.9% vs 7.7%, NS), treated patent ductus arteriosus (32.3% vs 10.7%, NS) and blood culture-positive sepsis (32.4% vs 1.7%, p < 0.001) was higher in infants in the Indian centre. Overall survival was 83% vs 87.2% (NS) in the Bengaluru and the London cohorts, respectively. Survival of infants born at ≤28 weeks gestation was lower in Bengaluru than in London [24 weeks: 33.0% vs 79.3% (NS); 25 weeks: 50.0% vs 78.9%, p = 0.02; 26 weeks: 45.2% vs 86.5%, p < 0.01; 27 weeks: 79.3% vs 91.3% (NS); 28 weeks 82.5% vs 94.1%, p = 0.03]. Conclusion The survival of infants ≤28 weeks gestation was significantly lower in the Bengaluru centre. Increasing the provision of antenatal corticosteroids may improve the outcome in these infants. Abbreviations BPD: bronchopulmonary dysplasia; CPAP: continuous positive airway pressure; EPR: electronic patient records; HIC: high-income countries; HDU: high dependency unit; hsPDA: haemodynamically significant patent ductus arteriosus; IVH: intraventricular haemorrhage; ITU: Intensive Care Unit, IUGR: intrauterine growth restriction; LAMA: leaving against medical advice; LMIC: low- and middle-income countries; NICU: neonatal intensive care unit; NNFI: National Neonatal Forum of India; NS: not significant; NTS: neonatal transfer service; NNAP: National Neonatal Audit Programme; NHM: National Health Mission; NMR: neonatal mortality rate; NEC: necrotising enterocolitis; NS: not significant; PDA: patent ductus arteriosus; ROP: retinopathy of prematurity; SCBU: special care baby unit; VLBW: very low birthweight; WHO: World Health Organization","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"5 - 11"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49040491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulcerative colitis in patients with sickle cell disease: a rare but important co-morbidity","authors":"Angela E. Rankine-Mullings","doi":"10.1080/20469047.2022.2084964","DOIUrl":"https://doi.org/10.1080/20469047.2022.2084964","url":null,"abstract":"Abbreviations : COVID-19: Coronavirus disease 2019; HIC: high-income countries; IBD: inflammatory bowel disease; LMIC: low- and middle-income countries; PUCAL: paediatric ulcerative colitis activity index; SCD: sickle cell disease; UC: ulcerative colitis","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"1 - 4"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43492889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spectrum and burden of in-patient paediatric musculoskeletal diseases in Northern Tanzania","authors":"Rebecca B Walsh, Anthon G Mwingwa, Nateiya M. Yongolo, S. M. Biswaro, M. Mwanswila, C. Kelly, B. Mmbaga, Faith Mosha, W. Gray, E. McIntosh, R. Walker","doi":"10.1080/20469047.2022.2062561","DOIUrl":"https://doi.org/10.1080/20469047.2022.2062561","url":null,"abstract":"ABSTRACT Background Musculoskeletal diseases (MSD) are a major contributor to the global burden of disease and disability, and disproportionally affect low- and middle-income countries; however, there is a dearth of epidemiological data. Affected children often face increased morbidity, social isolation and economic hardship. Aim To assess the spectrum and burden of paediatric MSD in children aged 5–18 years admitted to a major referral hospital in Tanzania. Methods This was a retrospective cohort study of children aged 5–18 years admitted to Kilimanjaro Christian Medical Centre (KCMC) whose initial diagnosis was recognised as a musculoskeletal condition by the International Classification of Diseases-10 between 1 January and 31 December 2017. Results During 2017, 163 cases of confirmed paediatric MSD were admitted to KCMC, representing 21.2% of all admissions of children aged 5–18 years (n = 769). Bone disease was the most common diagnosis. They comprised 106 (65.0%) traumatic fractures, 31 (19.0%) osteo-articular infections, 9 (5.5%) malunions and 3 (1.8%) pathological fractures. Congenital defects and rheumatic disease were relatively uncommon, accounting for only 6 (3.7%) and 4 (2.5%) MSD admissions, respectively. Conclusion The majority of cases of MSD were related to fractures, followed by osteo-articular infections, while recognised cases of rheumatic disease were rare. The study, although small, identified the sizeable burden and spectrum of paediatric MSD admitted to a hospital in Tanzania over a 12-month period and highlights the need for larger studies to inform the optimal allocation of health resources. Abbreviation CI: confidence interval; HIC: high-income countries; HIV: human immunodeficiency virus; ICD-10: International Classification of Diseases 10; IQR: interquartile range; JIA: juvenile idiopathic arthritis; KCMC: Kilimanjaro Christian Medical Centre; LMIC: low- and middle-income countries; MSD: musculoskeletal diseases: NAI: non-accidental injury; NIHR: National Institute for Health Research; PAFLAR: Paediatric Society of the African League Against Rheumatism; RTA: road traffic accidents; SCD: sickle cell disease; SLE: systemic lupus erythematosus; SSA: sub-Saharan Africa.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"12 - 21"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41812763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A subarachnoid pleural fistula with massive crystal-clear pleural fluid caused by a lumbar epidural teratoma","authors":"Toshihiro Fujiki, R. Nishimura, Raita Araki, M. Kuroda, Y. Tohma, H. Fujisawa, A. Yachie","doi":"10.1080/20469047.2022.2044675","DOIUrl":"https://doi.org/10.1080/20469047.2022.2044675","url":null,"abstract":"ABSTRACT A subarachnoid pleural fistula — a connection between the pleural cavity and the subarachnoid space — generally presents after trauma or surgery. A 1-year 11-month-old girl without a history of trauma or surgery presented with fatigue, cyanosis and dyspnoea. A chest radiograph and computed tomography (CT) demonstrated a massive pleural effusion in the right hemithorax. About 300 ml of a crystal-clear pleural effusion, which looked like pure water, was removed by insertion of a chest drain, but it continued to collect. Cisternography and CT myelography confirmed leakage of cerebral spinal fluid into the right pleural cavity around the thoracolumbar region. Magnetic resonance imaging demonstrated an 11-mm enhanced nodule in the epidural space around the right lumbar (L) 1/2 intervertebral foramen. The patient underwent surgery and epidural tumours attached to the L1 nerve root foramen were completely resected and a fistula of the dura adjacent to the tumour was sutured. Histopathological examination demonstrated a mature teratoma containing a pancreatic component. On retrospective analysis of stored pleural fluid, a raised level of pancreatic enzymes was detected. It is presumed that digestive enzymes secreted by the pancreatic component of the teratoma lysed the dura, resulting in formation of the fistula. When a crystal-clear pleural effusion is present, even in the absence of trauma or surgery, a subarachnoid pleural fistula should be considered. As far as we know, this is the first report of a subarachnoid pleural fistula caused by a paravertebral teratoma. Abbreviations: CSF: cerebrospinal fluid; CT: computed tomography; 111In-DTPA: indium-111 diethylene triamine penta-acetic acid; MRI: magnetic resonance imaging; NIPPV: non-invasive positive pressure ventilation.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"52 - 57"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41728793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between distance of referring facilities and haemoglobin change in children in Malawi.","authors":"Elizabeth M Keating,&nbsp;Jeff A Robison,&nbsp;Msandeni Chiume,&nbsp;Marissa Taddie,&nbsp;James A VanDerslice,&nbsp;L Scott Benson,&nbsp;Elizabeth Fitzgerald,&nbsp;Heather L Crouse,&nbsp;Michelle D Eckerle,&nbsp;Emily J Ciccone,&nbsp;Christina A Porucznik","doi":"10.1080/20469047.2022.2044674","DOIUrl":"https://doi.org/10.1080/20469047.2022.2044674","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is a significant cause of mortality in children in sub-Saharan Africa where blood transfusion is often available only at referral hospitals. Understanding the pattern of referrals by health facilities is essential to identify the delays that affect child survival.</p><p><strong>Aim: </strong>To determine if there was a correlation between change in haemoglobin (Hb) level and distance from referring facilities to Kamuzu Central Hospital (KCH) in Malawi, and whether distance affected mortality rates.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 2259 children referred to KCH whose Hb was measured at the referring facility or at KCH. Maps were created using ArcGIS® software. The relationship between distance from KCH and change in Hb was assessed by χ² analysis and multiple linear regression with SAS© software.</p><p><strong>Results: </strong>The majority of children were referred by health facilities in the Lilongwe District. When categorised as Hb <4, 4-6 or >6 g/dL, 87.0% of children remained in the same category during transfer. There was no significant relationship between Hb drop and distance from KCH. Distance from KCH was not a significant predictor of Hb level at KCH or Hb change. However, mortality rates were significantly higher in facilities that were 10-50 km from KCH than in those which were <10 km away.</p><p><strong>Conclusions: </strong>Using distance as a proxy for time, this suggests that referring facilities are transferring children sufficiently quickly to avert significant reductions in Hb. Despite this, there is a need to identify the factors that influence the decision to transfer anaemic children.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 4","pages":"253-261"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9050928/pdf/nihms-1784970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal depression and infant social withdrawal as predictors of behaviour and development in vertically HIV-infected children at 3.5 years","authors":"J. Nöthling, B. Laughton, S. Seedat","doi":"10.1080/20469047.2021.2023436","DOIUrl":"https://doi.org/10.1080/20469047.2021.2023436","url":null,"abstract":"ABSTRACT Background In low- and middle-income countries, there is a high prevalence of post-partum depression and it is often associated with HIV status. Maternal depression negatively affects mothering and can lead to social withdrawal in infants. Maternal depression and infant social withdrawal can have deleterious long-term effects on children’s behaviour and neurodevelopmental trajectories. Aim To investigate whether maternal depression and infant social withdrawal at 10–12 months post-partum were significant predictors of child behaviour and development at 42 months. Method Seventy-four mother–infant dyads living with HIV were followed in a prospective, longitudinal design. Mothers were assessed for depression using the Center for Epidemiologic Studies Depression scale (CES-D). Infant social withdrawal was assessed by the modified Alarm Distress Baby Scale (m-ADBB), and development and behaviour were evaluated by the Griffiths Mental Development Scales (GMDS) and the Child Behavior Checklist (CBCL), respectively. Results Maternal depression explained 4.8% of the variance in child behaviour (β = 0.98, t = 2.05, p < 0.05) and 10.3% of the variance in development (β = −0.30, t = −2.66, p < 0.05). Infant social withdrawal was not a significant predictor of behaviour (β = 3.27, t = 1.36, p = 0.18), but it did uniquely explain 7% of the variance in development (β = −1.32, t = −2.48, p < 0.05). Conclusion In the context of HIV, screening for maternal depression and the quality of mother–infant interactions are important (especially in the 1st year post-partum), given the significant long-term impact they have on behaviour and neurodevelopment. Abbreviations ANOVA: analysis of variance; ART: antiretroviral therapy; CBCL: Child Behavioral Checklist; CES-D: Center for Epidemiologic Studies Depression Scale; CHEI: children HIV-exposed and infected; CHER: Children with HIV Early Antiretroviral Treatment Trial; CHEU: children HIV-exposed and uninfected; CHUU: children HIV-unexposed and -uninfected; GMDS: Griffiths Mental Development Scales; HIV: human immunodeficiency virus; LMIC: low- and middle-income countries; m-ADBB: modified Alarm Distress Baby Scale; NRF: National Research Foundation; SAMRC: South African Medical Research Council; WHO: World Health Organization","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"268 - 277"},"PeriodicalIF":1.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44388009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe hypercalcaemia and acute renal failure in an infant with subcutaneous fat necrosis.","authors":"Tülay İnce Becerir,&nbsp;Ayça Altincik,&nbsp;Bayram Özhan,&nbsp;Selçuk Yüksel","doi":"10.1080/20469047.2021.1883960","DOIUrl":"https://doi.org/10.1080/20469047.2021.1883960","url":null,"abstract":"<p><p>Subcutaneous fat necrosis (SFN) in the newborn is a form of panniculitis which presents with erythematous nodules and indurated plaques. Severe life-threatening hypercalcaemia can occur as a late complication. A 2-month-old girl presented with severe hypercalcaemia and acute renal injury as a complication of SFN. She was admitted to hospital with the chief complaint of failure to thrive. She had a history of therapeutic hypothermia. After successful treatment of the hypercalcaemia with bisphosphonates, the acute renal injury recovered spontaneously. In neonates with SFN, acute renal injury is a rare complication of hypercalcaemia. Timely prevention of the complications of hypercalcaemia in SFN is essential.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 3","pages":"221-225"},"PeriodicalIF":1.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1883960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25474113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving recognition and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi: a quality improvement initiative.","authors":"Bryan J Vonasek,&nbsp;Susan Mhango,&nbsp;Heather L Crouse,&nbsp;Temwachi Nyangulu,&nbsp;Wilfred Gaven,&nbsp;Emily Ciccone,&nbsp;Alexander Kondwani,&nbsp;Binita Patel,&nbsp;Elizabeth Fitzgerald","doi":"10.1080/20469047.2021.1967627","DOIUrl":"https://doi.org/10.1080/20469047.2021.1967627","url":null,"abstract":"<p><strong>Background: </strong>Severe acute malnutrition (SAM) is common in low-income countries and is associated with high mortality in young children.</p><p><strong>Objective: </strong>To improve recognition and management of SAM in a tertiary hospital in Malawi.</p><p><strong>Methods: </strong>The impact of multifaceted quality improvement interventions in process measures pertaining to the identification and management of SAM was assessed. Interventions included focused training for clinical staff, reporting process measures to staff, and mobile phone-based group messaging for enhanced communication. This initiative focused on children aged 6-36 months admitted to Kamuzu Central Hospital in Malawi from September 2019 to March 2020. Before-after comparisons were made with baseline data from the year before, and process measures within this intervention period which included three plan-do-study-act (PDSA) cycles were compared.</p><p><strong>Results: </strong>During the intervention period, 418 children had SAM and in-hospital mortality was 10.8%, which was not significantly different from the baseline period. Compared with the baseline period, there was significant improvement in the documentation of full anthropometrics on admission, blood glucose test within 24 hours of admission and HIV testing results by discharge. During the intervention period, amidst increasing patient census with each PDSA cycle, three process measures were maintained (documentation of full anthropometrics, determination of nutritional status and HIV testing results), and there was significant improvement in blood glucose documentation.</p><p><strong>Conclusion: </strong>Significant improvement in key quality measures represents early progress towards the larger goal of improving patient outcomes, most notably mortality, in children admitted with SAM.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 3","pages":"177-187"},"PeriodicalIF":1.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671256/pdf/nihms-1736428.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39411897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis in a 2.5-month-old infant: congenital or acquired dilemma?","authors":"Yellanthoor Ramesh Bhat,&nbsp;Sandesh Kini,&nbsp;Lakshmikanth Halegubbi Karegowda","doi":"10.1080/20469047.2020.1848270","DOIUrl":"https://doi.org/10.1080/20469047.2020.1848270","url":null,"abstract":"<p><p>Infants may develop congenital tuberculosis from an infectious mother or acquire the disease postnatally by contact with an infectious adult. Delayed diagnosis is common, especially in infants under 1 year of age, and, if unrecognised, there is an increased risk of death. A 2.5-month-old boy presented with respiratory distress, small inhomogeneous opacities in both lungs and hepatosplenomegaly mimicking sepsis. He had received BCG vaccination and there was no history of contact with tuberculosis (TB). He had had fever since 1 month of age for which there had been several outpatient visits. Gastric aspirate cartridge-based nucleic acid amplification test (CBNAAT) confirmed TB and sonological evaluation demonstrated multiple granulomata in the liver and spleen, and a liver biopsy supported TB. He responded well to 12 months of anti-tuberculous treatment. The mother's tuberculin test, chest radiograph and endometrial biopsy showed no evidence of TB. There was no history of tuberculous contact with close family members. Despite the lack of proof of current tuberculous TB infection in the mother, it is likely that the infant had congenital TB.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 3","pages":"217-220"},"PeriodicalIF":1.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1848270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38715463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}