围产期肺结核:一个需要考虑的诊断

Layla Silveira, Williane Fernandes, Allyne Monteiro, L. Valle, A. Soares, D. Barbosa, Deborah Rodrigues, I. Lima, Larisse Leal, Luiza Horst Neto, Pollyanna Resende
{"title":"围产期肺结核:一个需要考虑的诊断","authors":"Layla Silveira, Williane Fernandes, Allyne Monteiro, L. Valle, A. Soares, D. Barbosa, Deborah Rodrigues, I. Lima, Larisse Leal, Luiza Horst Neto, Pollyanna Resende","doi":"10.25060/residpediatr-2023.v13n2-540","DOIUrl":null,"url":null,"abstract":"BACKGROUND: Perinatal Tuberculosis (TB) is a rare disease, transmitted during pregnancy or postnatal. Its clinical presentation is similar to congenital infections and neonatal sepsis, thus, remains underestimated and underdiagnosed. CASE PRESENTATION: A 34 week female child, born vaginally, with no prenatal intercurrences. Was admitted in neonatal Intensive Care Unit (ICU) in need of ventilatory support and antibiotic therapy for presumed neonatal sepsis. During the case evolution, a treatment for suspected fungical sepsis was initiated, and after 48h, the newborn showed bilateral otitis media and otomastoiditis. Meanwhile, the newborns mother was hospitalized with miliar TB. Thereby, the newborn was treated for latent TB with Rifampicin, and a lymph node exeresis was made for tuberculosis quick testing (TRM-Ultra) and culture. Since the TRM-Ultra was positive, the treatment was switched to Rifampicin, Isoniazid and Pyrazinamide in order to treat presumed Perinatal TB. The newborn has evolved well and the culture demonstrated Mycobacterium tuberculosis. DISCUSSION: The congenital form of Perinatal TB is transmitted intrauterus by mothers with severe and/or genital TB, while postnatal occurs due to newborns contact with bacilliferous individual after birth. The diagnosis, as the differentiation between the two forms, are hampered by non-specific clinical manifestations. CONCLUSION: This case demonstrates the importance of considering perinatal TB in unspecified symptomatology cases that are not responsive to conventional antibiotic therapy. Despite the uncertainty regarding the time of infection, besides late diagnosis and treatment, the patient obtained a satisfactory clinical outcome.","PeriodicalId":338092,"journal":{"name":"Residência Pediátrica","volume":"46 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perinatal tuberculosis: a diagnosis to be considered\",\"authors\":\"Layla Silveira, Williane Fernandes, Allyne Monteiro, L. Valle, A. Soares, D. Barbosa, Deborah Rodrigues, I. Lima, Larisse Leal, Luiza Horst Neto, Pollyanna Resende\",\"doi\":\"10.25060/residpediatr-2023.v13n2-540\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND: Perinatal Tuberculosis (TB) is a rare disease, transmitted during pregnancy or postnatal. Its clinical presentation is similar to congenital infections and neonatal sepsis, thus, remains underestimated and underdiagnosed. CASE PRESENTATION: A 34 week female child, born vaginally, with no prenatal intercurrences. Was admitted in neonatal Intensive Care Unit (ICU) in need of ventilatory support and antibiotic therapy for presumed neonatal sepsis. During the case evolution, a treatment for suspected fungical sepsis was initiated, and after 48h, the newborn showed bilateral otitis media and otomastoiditis. Meanwhile, the newborns mother was hospitalized with miliar TB. Thereby, the newborn was treated for latent TB with Rifampicin, and a lymph node exeresis was made for tuberculosis quick testing (TRM-Ultra) and culture. Since the TRM-Ultra was positive, the treatment was switched to Rifampicin, Isoniazid and Pyrazinamide in order to treat presumed Perinatal TB. The newborn has evolved well and the culture demonstrated Mycobacterium tuberculosis. DISCUSSION: The congenital form of Perinatal TB is transmitted intrauterus by mothers with severe and/or genital TB, while postnatal occurs due to newborns contact with bacilliferous individual after birth. The diagnosis, as the differentiation between the two forms, are hampered by non-specific clinical manifestations. CONCLUSION: This case demonstrates the importance of considering perinatal TB in unspecified symptomatology cases that are not responsive to conventional antibiotic therapy. Despite the uncertainty regarding the time of infection, besides late diagnosis and treatment, the patient obtained a satisfactory clinical outcome.\",\"PeriodicalId\":338092,\"journal\":{\"name\":\"Residência Pediátrica\",\"volume\":\"46 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1900-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Residência Pediátrica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.25060/residpediatr-2023.v13n2-540\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Residência Pediátrica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.25060/residpediatr-2023.v13n2-540","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:围产期结核病(TB)是一种罕见的疾病,在妊娠或产后传播。它的临床表现与先天性感染和新生儿败血症相似,因此仍然被低估和未被诊断。病例介绍:一名34周的女婴,顺产,无产前并发症。在新生儿重症监护病房(ICU),需要通气支持和抗生素治疗推定新生儿败血症。在病例发展过程中,开始了疑似真菌脓毒症的治疗,48小时后,新生儿表现为双侧中耳炎和耳乳突炎。与此同时,新生儿母亲因常见的结核病住院。因此,新生儿用利福平治疗潜伏性结核病,并进行淋巴结检查,进行结核病快速检测(TRM-Ultra)和培养。由于TRM-Ultra呈阳性,治疗改为利福平、异烟肼和吡嗪酰胺,以治疗推定的围产期结核病。新生儿进化良好,培养显示结核分枝杆菌。讨论:围产期结核病的先天性形式是由患有严重和/或生殖器结核病的母亲在子宫内传播的,而产后则是由于新生儿在出生后与细菌个体接触而发生的。诊断,作为两种形式的区分,阻碍了非特异性的临床表现。结论:该病例表明,在未明确症状且对常规抗生素治疗无反应的病例中,考虑围产期结核病的重要性。尽管感染时间不确定,但除了早期诊断和治疗外,患者获得了满意的临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perinatal tuberculosis: a diagnosis to be considered
BACKGROUND: Perinatal Tuberculosis (TB) is a rare disease, transmitted during pregnancy or postnatal. Its clinical presentation is similar to congenital infections and neonatal sepsis, thus, remains underestimated and underdiagnosed. CASE PRESENTATION: A 34 week female child, born vaginally, with no prenatal intercurrences. Was admitted in neonatal Intensive Care Unit (ICU) in need of ventilatory support and antibiotic therapy for presumed neonatal sepsis. During the case evolution, a treatment for suspected fungical sepsis was initiated, and after 48h, the newborn showed bilateral otitis media and otomastoiditis. Meanwhile, the newborns mother was hospitalized with miliar TB. Thereby, the newborn was treated for latent TB with Rifampicin, and a lymph node exeresis was made for tuberculosis quick testing (TRM-Ultra) and culture. Since the TRM-Ultra was positive, the treatment was switched to Rifampicin, Isoniazid and Pyrazinamide in order to treat presumed Perinatal TB. The newborn has evolved well and the culture demonstrated Mycobacterium tuberculosis. DISCUSSION: The congenital form of Perinatal TB is transmitted intrauterus by mothers with severe and/or genital TB, while postnatal occurs due to newborns contact with bacilliferous individual after birth. The diagnosis, as the differentiation between the two forms, are hampered by non-specific clinical manifestations. CONCLUSION: This case demonstrates the importance of considering perinatal TB in unspecified symptomatology cases that are not responsive to conventional antibiotic therapy. Despite the uncertainty regarding the time of infection, besides late diagnosis and treatment, the patient obtained a satisfactory clinical outcome.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信