Tuesday, 25 August 2015

Congenital TB

Infection  with tubercle  bacilli  either during intrauterine  life  or before  complete  passage through birth canal  is termed  as  congenital  tuberculosis.   Three  possible  modes  of infection of fetus:-
1)  Hematogenous  infection  via  umbilical vein
2)  fetal  aspiration of infected  amniotic  fluid  
3)  fetal  ingestion of infected amniotic  fluid

 Most common primary site  -----  LIVER  (  primary complex in liver is suggestive   of  congenital  TB) 
Most common   site  ---  LUNG ( prognosis  is poor )

Revised  criteria for diagnosis  of congenital  tuberculosis ( by Cantwell  ) :-
 Proven tuberculosis lesions  in the  infant  plus  one  of the  following:
i.  Lesions  occurring in the  first  week of life,
ii. A  primary hepatic  complex
iii.  Maternal genital tract or  placental tuberculosis,  and
iv.  Exclusion of postnatal  transmission by thorough  investigation of contacts.

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