© 2005 Archives of Disease in Childhood Fetal and Neonatal Edition
COMMENTARY
Commentary on "Pulmonary tuberculosis and extreme prematurity"
Children’s Hospital at Westmead, Westmead, NSW 2145, Australia and University of Sydney; davidi@chw.edu.au
| The first 150 words of the full text of this article appear below. |
Katumba-Lunyenya et al present a fascinating but sad case.
Neonatal tuberculosis is usually caused by someone, usually the mother, with open pulmonary tuberculosis coughing on the baby.1 This mother apparently did not have open tuberculosis, so spread must have been transplacental, leading to disseminated, congenital tuberculosis. Did the baby have clinical or autopsy evidence of extrapulmonary tuberculosis?
Most children with tuberculosis disease are not contagious. Exceptions include children with adult-type cavitary lung disease, those with sputum that is smear positive for acid fast bacilli, and those with congenital tuberculosis.2 This baby falls into both the last two categories, and artificial ventilation is likely to have increased the dissemination of bacilli by aerosol, as happens when a patient with chickenpox is ventilated.
It is simplistic to say that a high index of suspicion of the diagnosis of neonatal tuberculosis, with early empirical treatment and isolation of suspect cases, is ideal. Neonatal
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