Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5495-5501
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5495
Congenital tuberculosis with tuberculous meningitis and situs inversus totalis: A case report
Hu Lin, Shuang Teng, Zhong Wang, Qi-Yu Liu
Hu Lin, Qi-Yu Liu, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Shuang Teng, School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610036, Sichuan Province, China
Zhong Wang, Department of Radiology, Mianyang Central Hospital, Mianyang 621000, Sichuan Province, China
Author contributions: Lin H, a radiologist, reviewed the literature, participated in the drafting of the manuscript, and interpreted the imaging findings; Teng S and Wang Z reviewed the literature and contributed to manuscript drafting; Liu QY was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: No conflicting relationship exists for any author.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi-Yu Liu, MD, Chief Doctor, Professor, Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 Taiping street, Luzhou 646000, China. lqy2225085@163.com
Received: December 21, 2021
Peer-review started: December 21, 2021
First decision: January 25, 2022
Revised: January 30, 2022
Accepted: April 29, 2022
Article in press: April 29, 2022
Published online: June 6, 2022
Processing time: 162 Days and 19.6 Hours
Abstract
BACKGROUND

Congenital tuberculosis (TB), tuberculous meningitis, and situs inversus totalis are rare diseases. We here report a patient who simultaneously suffered from these three rare diseases. There is currently no such report in the literature. Congenital TB is easily misdiagnosed and has a high case fatality rate. Timely anti-TB treatment is required.

CASE SUMMARY

A 19-day-old male newborn was admitted to hospital due to a fever for 6 h. His blood tests and chest X-rays suggested infection, and he was initially considered to have neonatal pneumonia and sepsis. He did not respond to conventional anti-infective treatment. Finally, Mycobacterium tuberculosis was found in sputum lavage fluid on the 10th day after admission. In addition, the mother's tuberculin skin test was positive, with an induration of 22 mm, and her pelvic computed tomography scan suggested the possibility of tuberculous pelvic inflammatory disease. The child was diagnosed with congenital TB and immediately managed with anti-TB therapy and symptomatic supportive treatment. However, the infant's condition gradually worsened and he developed severe tuberculous pneumonia and tuberculous meningitis, and eventually died of respiratory failure.

CONCLUSION

If conventional anti-infective treatment is ineffective in neonatal pneumonia, anti-TB treatment should be considered.

Keywords: Tuberculosis; Congenital; Situs inversus; Newborn; Infant; Case report

Core Tip: Congenital tuberculosis (TB) is rare in the clinic, and early diagnosis is challenging. The disease develops rapidly, and the mortality rate is exceptionally high. In the present case, the infant's condition worsened due to delays in diagnosis and anti-TB treatment, and he developed severe tuberculous pneumonia and tuberculous meningitis, and eventually died of respiratory failure. Early screening of TB infection and anti-TB treatment are essential to reduce mortality and improve the prognosis in children who do not respond to conventional anti-infective therapy.