Background: Little is known about the course and management of perinatal tuberculosis (TB). We describe the presentation, medical and surgical management of culture-confirmed TB in infants younger than 3 months of age.
Methods: We conducted a retrospective study including all infants younger than 3 months of age with culture-confirmed TB admitted to Tygerberg Hospital, Cape Town, South Africa, from March 2003 to June 2015.
Results: During the study period, 106 of 2017 (5%) children younger than 13 years of age with culture-confirmed TB were infants younger than 3 months of age. The median age on admission was 67 days (interquartile range, 40-79). Intrathoracic TB was present in 101 (95%) infants; of these, 34 (32%) had extrathoracic TB. Two (2%) infants had extrathoracic TB only, while 3 (3%) infants were asymptomatic and diagnosed as having TB infection only. Forty (38%) infants were HIV-exposed, and 14 (13%) were HIV-infected. The mother was identified as the source case in 53 (50%) infants. Mycobacterium tuberculosis was cultured in a median of 2 (interquartile range, 1-7) specimens per infant; 9 (9%) had drug-resistant TB. Bronchoscopy was done in 37 (35%) infants, and 27 (26%) underwent intrathoracic lymph node decompression. Twelve (11%) infants died during admission, 81(76%) were clinically stable on transfer or discharge from hospital, and outcome was not documented in 13 (12%) infants.
Conclusions: TB in young infants often presents with severe intrathoracic disease, including airway compression. Bronchoscopy may aid confirmation of the diagnosis and management; decompression of intrathoracic lymph nodes was common. Mortality in this age group remains high.
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http://dx.doi.org/10.1097/INF.0000000000002163 | DOI Listing |
Eur Radiol
January 2025
Departments of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Chest imaging in children presents unique challenges due to varying requirements across age groups. For chest radiographs, achieving optimal images often involves careful positioning and immobilisation techniques. Antero-posterior projections are easier to obtain in younger children, while lateral decubitus radiographs are sometimes used when expiratory images are difficult to obtain and for free air exclusion.
View Article and Find Full Text PDFNat Commun
January 2025
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA.
ETV6::RUNX1 is the most common fusion gene in childhood acute lymphoblastic leukemia (ALL) associated with favorable prognosis, but the optimal therapy for this subtype remains unclear. Profiling the genomic and pharmacological landscape of 194 pediatric ETV6::RUNX1 ALL cases, we uncover two transcriptomic clusters, C1 (61%) and C2 (39%). Compared to C1, the C2 subtype features higher white blood cell counts and younger age at diagnosis, as well as better early treatment responses.
View Article and Find Full Text PDFClin Pediatr (Phila)
February 2025
Department of Pediatric Surgery, St. John's Medical College Hospital, Bangalore, Karnataka, India.
Renal histologic changes in congenital ureteropelvic junction obstruction (UPJO), although well documented, are sparsely studied in children. This study aims to establish a histological grading depending on the glomerular and tubulo-interstitial changes in hydronephrotic kidneys and determine correlation with age at surgery and impact on function post-pyeloplasty. A renal cortical wedge biopsy was obtained after pyeloplasty and histological changes were graded from 1 to 4.
View Article and Find Full Text PDFJ Child Neurol
January 2025
Department of Neurosurgery, University Hospital Ostrava, Ostrava, Czech Republic.
Introduction: The indication for endoscopic third ventriculostomy is often contested in children younger than 1 year. This study aims to establish the benefits of this modality in children with idiopathic congenital aqueductal stenosis.
Methods: Retrospective analysis was performed on patients <1 year old with idiopathic congenital aqueductal stenosis undergoing endoscopic third ventriculostomy between 2004 and 2020.
Eur J Clin Microbiol Infect Dis
January 2025
National reference centre for Haemophilus influenzae, Department of microbiology, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Université libre de Bruxelles, Brussels, Belgium.
Introduction: Haemophilus influenzae plays a major role in invasive bacterial infections. Resistant strains are emerging, prompting the WHO to include H. influenzae on its list of priority pathogens for research and development of new antibiotics.
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