Jump to content

Featured Replies

Posted

We have a 1 month male baby, who has been referred for hepato-splenomegale, and peritoneal lymphadenopathy , confirmed by ultrasound abdomen , no other significant history , no fever no other signs of sepsis.

Anti-natal history of mother getting on and off fever from gestation of 5 months,

Mother u/s ab : omental thickening, ? TB

Baby on DBF

We suspected sepsis, lymphomas , infiltrative disorder , congenital tuberculosis .

Sepsis screening - negative , baby is not sick

TB; gastric aspirate, PCR for TB is negative

LFT-normal, PT ptt : Normal

Immunoglobulin levels -normal

VDRL, HIV, NEgative

Hb: 9.5, TC : 9000, platelets : 1.2L

Bone marrow - ? Normal study

Please give your opinion , what to do further ,

THANKYOU

suspected congenital tuberculosis is a tough one; is the mother on TB treatment?

a) What did the baby's CXR reveal (although congenital TB can present with no CXR findings initially, it will still be worth checking)

B) mantoux interpretation and TB interferon gamma assay (TB Elispot) aalso difficult to interpret in endemic environment and considering age; nevertheless a positive result would indicate infection at least and with symptomatology you would be obliged to treat as Tb disease

In my experience, with suspected maternal TB in an endemic setting for TB, and a baby symptomatic for a chronic infection, we have offered a course of TB treatment.

Will also be worth checking CMV status

  • Author

Mother TB screening is negative,

Mother not on TB Rx ,

TORCH PROFILE IS NEGATIVE

Baby chest x ray normal

Now we r working towards infiltrative disorders

Sent for kariotyping ,

  • 3 weeks later...
  • Author

Transient myeloproliferative disorder (TMT )

suspected by hematologist, but cytogenetic is normal study

How to move forward ?

Create an account or sign in to comment