摘要
先天性结核病是婴儿在母体宫内或正常分娩过程中感染结核分枝杆菌所致的一种罕见结核病,一般因肺外结核、结核性脑膜炎等严重类型的妊娠期结核病患者通过胎盘、母体生殖道或羊水感染胎儿所致。先天性结核病的发病日龄不一,临床症状与实验室检查均与细菌性肺炎等传染性疾病相似,缺乏特异性,易误诊,其诊断需结合临床症状、影像学检查、病原学证据、T-SPOT等结核特异性检查、母亲妊娠期结核病史综合考虑,由于其病情进展迅速,病死率高,一般临床确诊后即可开始进行抗结核治疗。目前,文献报道较多患儿是在使用多种抗生素治疗无效后才考虑先天性结核病的诊断,延误了治疗时机,从而造成严重后果,及时诊断及适当的治疗可明显降低患儿病死率。为更好认识该疾病,笔者就先天性结核病的定义、传播途径、临床表现、辅助检查、诊断、治疗及预防等方面进行综述,以供读者参考借鉴。
Congenital tuberculosis is a rare type of tuberculosis caused by Mycobacterium tuberculosis infection during the intrauterine or normal parturition.It is caused by severe forms of tuberculosis in pregnancy such as extrapulmonary tuberculosis and meningeal tuberculosis,which infect the fetus through the placenta,amniotic fluid or maternal genital tract.The onset of congenital tuberculosis varies in age.There is easy to be misdiagnosed because congenital tuberculosis is lacking specificity and is similar to infectious diseases such as bacterial pneumonia for clinical symptoms and laboratory examination.We should combine diagnosis with clinical symptoms,imaging examination,etiological evidence,tuberculosis specific examination such as T-SPOT,and maternal history of tuberculosis during pregnancy.The disease progresses is quick and the fatality rate is high.So anti-tuberculosis treatment can be started after general clinical diagnosis.At present,Many literatures had been reported that diagnosis of congenital tuberculosis was considered only after the treatment with multiple antibiotics failed,which caused serious consequences in infants.So it is necessary to early diagnosis and appropriate treatment for reducing the fatality rate of infants.To providing further understanding for clinic reference,we have briefly summarized the definition,infection passway,clinical manifestations,accessory examination,diagnosis,treatment and prevention of congenital tuberculosis.
作者
谢东胜
邓国防
韩婷婷
Xie Dongsheng;Deng Guofang;Han Tingting(Respiratory Department of Beihai Tuberculosis Prevention and Control Hospital of Guangxi,Guangxi Beihai 536000,China;The Second Department of Pulmonary Diseases,Shenzhen Third People's Hospital Affiliated to the Guangdong Medical University,Guangdong Shenzhen 518112,China;The First Clinical School of Medicine,Guangdong Medical University,Guangdong Zhanjiang 524023,China)
出处
《新发传染病电子杂志》
2023年第3期74-78,共5页
Electronic Journal of Emerging Infectious Diseases
基金
深圳市高水平医院建设专项经费(G2021015)
佛山市高水平医院登峰计划项目(FSSYKF-2020001)。
关键词
结核病
先天性
婴儿
临床表现
诊断
Tuberculosis
Congenital
Infant
Clinical presentation
Diagnosis
