Neonatal Tuberculosis in Preterm Infants Admitted to a Neonatal Intensive Care Unit in the United Arab Emirates

Introduction: Congenital tuberculosis is a rare but serious form of tuberculosis that occurs due to intra-or perinatal transmission of Mycobacterium tuberculosis (M.tuberculosis) from an infected mother to the fetus/infant.We present cases of three premature infants treated at our unit. Clinical features:Case 1: A significantly ill mother delivered a female infant at 27 weeks, who tested negative in her initial screening for tuberculosis.However, she deteriorated on postnatal day 40, and the gastric aspirates showed acid-fast bacilli (AFB).There was a good clinical response to antituberculosis treatment.Cases 2 and 3: Our second and third patients were dichorionic-diamniotic twins born at 26 +5 weeks' gestation.Twin 2 was on minimal respiratory support until postnatal day 37, when he worsened despite antibiotic therapy; the cultures remained negative.Gastric aspirates for AFB were positive.Once the diagnosis of TB was confirmed in this twin, gastric aspirate samples from twin 1 were tested for AFB but showed inconclusive results.The infant developed progressively worsening respiratory distress on postnatal day 50; he showed a good clinical response to empiric antituberculosis treatment. Conclusion:Congenital tuberculosis can present with a myriad of signs/symptoms that are often nonspecific.There can be important hints in maternal history and clinical deterioration despite conventional antibiotics.These infants then need to be evaluated specifically for mycobacterial infections.