Clinical characteristics and post-discharge follow-up analysis of 10 cases of congenital tuberculosis: a retrospective observational study

Abstract Background Congenital tuberculosis (TB) is a rare disease with a high mortality. In this study, we reviewed patients with congenital TB that were promptly treated with an anti-TB regimen, including linezolid, based on new clinical diagnosis criteria. We described the clinical manifestations, treatment, and long-term prognosis of this disease in these patients. Methods This was a retrospective observational study that enrolled patients with congenital TB that were admitted to Beijing Children’s Hospital between 2009 and 2018. Results A total of 10 congenital TB patients were enrolled. Ninety-percentage of the mothers were diagnosed at postpartum; however, none of the mothers received anti-TB treatment during pregnancy. The onset age of congenital TB ranged from 1 to 53 days. Chest computed tomography scans demonstrated pulmonary nodules in 100% of the patients and mediastinal adenopathy in 40% of the patients. Abdominal ultrasonography showed hypoechoic nodules in the liver and spleen in 40% of the patients. The positive rate of GeneXpert and T-spot were relatively high—80% and 78%, respectively. Anti-TB treatment was started when congenital TB was confirmed for 1 patient based on TB-specific tests or clinically diagnosed for the other 9 patients based on confirmed maternal TB history and typical radiological findings. Beside isoniazid, rifampicin, and pyrazinamide, linezolid was also administrated in 70% of the patients for a period of 2–6 months. One patient was reported to present with spontaneously resolved thrombocytopenia. The survival rate was 100%, and 33% of the patients have thrived and reached normal developmental milestones since the last documented follow-up. Conclusion Congenital TB is a potentially fatal disease, but early diagnosis based on maternal history, typical imaging results, and timely treatment can improve the outcome. Linezolid is safe and might be effective in reducing the mortality of congenital TB.