Cargando…
Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report)
Perinatal tuberculosis (TB) is a rare infectious disease. The diagnosis of perinatal TB is challenging due to its nonspecific clinical manifestations make it difficult to differentiate from other infections, resulting in a high mortality rate of 40-60%. Here we report a 26-day-old neonate with fever...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653542/ https://www.ncbi.nlm.nih.gov/pubmed/36425542 http://dx.doi.org/10.11604/pamj.2022.42.303.36463 |
_version_ | 1784828705268301824 |
---|---|
author | Raymond, Sitanaja Subekti, Helen Mayasari Sitompul, Abed Ricky Hernando |
author_facet | Raymond, Sitanaja Subekti, Helen Mayasari Sitompul, Abed Ricky Hernando |
author_sort | Raymond, Sitanaja |
collection | PubMed |
description | Perinatal tuberculosis (TB) is a rare infectious disease. The diagnosis of perinatal TB is challenging due to its nonspecific clinical manifestations make it difficult to differentiate from other infections, resulting in a high mortality rate of 40-60%. Here we report a 26-day-old neonate with fever, cough, fast breathing, poor feeding, subcostal retraction, bilateral crackles, hepatomegaly, and signs of shock. Clinically, septic shock and pneumonia were suspected. Respiratory distress worsened despite broad-spectrum antibiotics, and kept getting worse up to the point that intubation and assisted mechanical ventilation were needed. The examination of acid-fast bacteria (AFB) stain on the endotracheal aspirate showed a positive result. The patient was diagnosed as having perinatal TB, then treated with anti-TB regimens (isoniazid, rifampicin, pyrazinamide, ethambutol), as well as prednisone and other supportive medical care. Recurrent septic shock, laryngeal edema, and a possibility of ventilator-associated pneumonia (VAP) worsened the patient’s condition. The patient eventually passed away on the 71(st) day of care. In conclusion, perinatal TB should be suspected in any neonates with fever, respiratory distress, and hepatosplenomegaly, particularly in those from endemic areas, which fail to respond to broad-spectrum antibiotics. Early diagnosis and treatment are crucial to improve the prognosis of perinatal TB. |
format | Online Article Text |
id | pubmed-9653542 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-96535422022-11-23 Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) Raymond, Sitanaja Subekti, Helen Mayasari Sitompul, Abed Ricky Hernando Pan Afr Med J Case Report Perinatal tuberculosis (TB) is a rare infectious disease. The diagnosis of perinatal TB is challenging due to its nonspecific clinical manifestations make it difficult to differentiate from other infections, resulting in a high mortality rate of 40-60%. Here we report a 26-day-old neonate with fever, cough, fast breathing, poor feeding, subcostal retraction, bilateral crackles, hepatomegaly, and signs of shock. Clinically, septic shock and pneumonia were suspected. Respiratory distress worsened despite broad-spectrum antibiotics, and kept getting worse up to the point that intubation and assisted mechanical ventilation were needed. The examination of acid-fast bacteria (AFB) stain on the endotracheal aspirate showed a positive result. The patient was diagnosed as having perinatal TB, then treated with anti-TB regimens (isoniazid, rifampicin, pyrazinamide, ethambutol), as well as prednisone and other supportive medical care. Recurrent septic shock, laryngeal edema, and a possibility of ventilator-associated pneumonia (VAP) worsened the patient’s condition. The patient eventually passed away on the 71(st) day of care. In conclusion, perinatal TB should be suspected in any neonates with fever, respiratory distress, and hepatosplenomegaly, particularly in those from endemic areas, which fail to respond to broad-spectrum antibiotics. Early diagnosis and treatment are crucial to improve the prognosis of perinatal TB. The African Field Epidemiology Network 2022-08-23 /pmc/articles/PMC9653542/ /pubmed/36425542 http://dx.doi.org/10.11604/pamj.2022.42.303.36463 Text en Copyright: Sitanaja Raymond et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Raymond, Sitanaja Subekti, Helen Mayasari Sitompul, Abed Ricky Hernando Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title | Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title_full | Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title_fullStr | Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title_full_unstemmed | Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title_short | Perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of Asmat Regency of South Papua, Indonesia (case report) |
title_sort | perinatal tuberculosis: a diagnostic and treatment challenge in a remote area of asmat regency of south papua, indonesia (case report) |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653542/ https://www.ncbi.nlm.nih.gov/pubmed/36425542 http://dx.doi.org/10.11604/pamj.2022.42.303.36463 |
work_keys_str_mv | AT raymondsitanaja perinataltuberculosisadiagnosticandtreatmentchallengeinaremoteareaofasmatregencyofsouthpapuaindonesiacasereport AT subektihelenmayasari perinataltuberculosisadiagnosticandtreatmentchallengeinaremoteareaofasmatregencyofsouthpapuaindonesiacasereport AT sitompulabedrickyhernando perinataltuberculosisadiagnosticandtreatmentchallengeinaremoteareaofasmatregencyofsouthpapuaindonesiacasereport |