Abnormal Development - Tuberculosis

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Introduction

Mycobacterium Tuberculosis (scanning EM, Image CDC)
Robert Koch (1843 - 1910) Discoverer of Mycobacterium tuberculosis, the organism that causes tuberculosis and was awarded the Nobel Prize in Physiology or Medicine in 1905.

The gram-positive bacterium Mycobacterium tuberculosis causes the disease Tuberculosis (TB) usually initially infecting the lungs. The infection can cross the placenta to infect the fetus infecting many different systems (liver, bones, kidneys, spleen, gastrointestinal tract, skin, lymph nodes).

More than two billion people, one third of the world's total population, are infected with TB bacilli, an airborne infectious disease that is preventable and curable. The Bacillus Calmette-Guérin (BCG) vaccine was first used in 1921 as a vaccine for tuberculosis disease and also used in some countries to prevent childhood tuberculous meningitis and miliary disease.

Congenital tuberculosis cases are rare with a relatively high mortality rate.[1]

Postnatal infant infection can occur as a result of inhalation of bacilli at or soon after birth, ingestion of infected breast milk, or contamination of traumatized skin or mucous membranes.


Bacterial Links: bacterial infection | syphilis | gonorrhea | tuberculosis | listeria | salmonella | TORCH | Environmental | Category:Bacteria

Some Recent Findings

  • Fact and fiction in tuberculosis vaccine research: 10 years later[2] "Tuberculosis is one of the most deadly infectious diseases. The situation is worsening because of co-infection with HIV and increased occurrence of drug resistance. Although the BCG vaccine has been in use for 90 years, protection is insufficient; new vaccine candidates are therefore needed. 12 potential vaccines have gone into clinical trials."
  • Increased risk of low birthweight and small for gestational age infants among women with tuberculosis[3] "We concluded that women diagnosed with TB during pregnancy are at increased risk for having low birthweight (LBW) and small for gestational age (SGA) babies, compared with unaffected mothers. We suggest that clinicians should make women with TB aware of the potential risks before planning a child."
More recent papers  
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Search term: Tuberculosis

Older papers  
These papers originally appeared in the Some Recent Findings table, but as that list grew in length have now been shuffled down to this collapsible table.

See also the Discussion Page for other references listed by year and References on this current page.

Global Tuberculosis (new cases 2007)

WHO Report 2007 - Global tuberculosis new cases 2007.jpg

Drug-Resistant Tuberculosis

Extensively drug-resistant tuberculosis (XDR-TB2) is a highly drug-resistant strain subset of multidrug-resistant TB (MDR-TB) that have significantly worse outcomes, has now been reported in more than 50 countries. (WHO data)

Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to the two most powerful first-line anti-TB drugs (isoniazid and rifampicin).

Extensively drug-resistant tuberculosis (XDR-TB2) is defined as MDR-TB plus resistance to the most powerful second-line anti-TB drugs (any fluoroquinolone and any of the three injectable drugs: amikacin, capreomycin and kanamycin).


Australian NHMRC Guidelines

NHMRC Guidelines "are intended to promote health, prevent harm, encourage best practice and reduce waste" have replaced the earlier historic 1988 NHMRC recommendations.

Links: Clinical Practice Guidelines - Pregnancy Care (2019) | PDF | Related Documents | Australian Clinical Practice Guidelines | NHMRC guidelines


Historic - NHMRC (1988) Recommendations  
Historic Disclaimer - information about historic embryology pages 
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Neonates be assessed for follow-up care under the following conditions:

  • Birthweight less than 1500g or gestational age less than 32 weeks
  • Small-for-gestational-age neonates
  • Perinatal asphyxia
  • Apgar score less than 3 at 5 minutes
  • clinical evidence of neurological dysfunction
  • delay in onset of spontaneous respiration for more than 5 minutes and requiring mechanical ventilation
  • Clinical evidence of central nervous system abnormalities ie., seizures, hypotonia
  • Hyperbilirubinaemia of greater than 350umol/l in full term neonates
  • Genetic, dysmorphic or metabolic disorders or a family history of serious genetic disorder
  • Perinatal or serious neonatal infection including children of mothers who are HIV positive
  • Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.


2006 Communicable Diseases Intelligence Volume 30 Number 1, March 2006 - The BCG vaccine: information and recommendations for use in Australia

BCG vaccination is not recommended for general use in the Australian population.

BCG is recommended for:

  1. Aboriginal neonates in areas of high incidence of TB (e.g. Northern Territory, Far North Queensland, northern areas of Western Australia and South Australia).
  2. neonates and children 5 years and under who will be travelling or living in countries or areas with a high prevalence of TB for extended periods.
  3. neonates born to parents with leprosy or a family history of leprosy.

In addition to these recommendations BCG may be considered in the following:

  1. Children over 5 years who will be travelling or living in countries or areas with a high prevalence of TB for extended periods.
  2. Health care workers (HCWs) who may be at high risk of exposure to drug resistant cases.


References

  1. Peng W, Yang J & Liu E. (2011). Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009. Pediatr. Pulmonol. , 46, 1215-24. PMID: 21626715 DOI.
  2. Kaufmann SH. (2011). Fact and fiction in tuberculosis vaccine research: 10 years later. Lancet Infect Dis , 11, 633-40. PMID: 21798463 DOI.
  3. Lin HC, Lin HC & Chen SF. (2010). Increased risk of low birthweight and small for gestational age infants among women with tuberculosis. BJOG , 117, 585-90. PMID: 20156210 DOI.

Reviews

Borrell S & Gagneux S. (2011). Strain diversity, epistasis and the evolution of drug resistance in Mycobacterium tuberculosis. Clin. Microbiol. Infect. , 17, 815-20. PMID: 21682802 DOI.

Articles

Peker E, Bozdoğan E & Doğan M. (2010). A rare tuberculosis form: congenital tuberculosis. Tuberk Toraks , 58, 93-6. PMID: 20517736

Neyaz Z, Gadodia A, Gamanagatti S & Sarthi M. (2008). Imaging findings of congenital tuberculosis in three infants. Singapore Med J , 49, e42-6. PMID: 18301825

Vilarinho LC. (2006). Congenital tuberculosis: a case report. Braz J Infect Dis , 10, 368-70. PMID: 17293929

Chen A & Shih SL. (2004). Congenital tuberculosis in two infants. AJR Am J Roentgenol , 182, 253-6. PMID: 14684547 DOI.

Stähelin-Massik J, Carrel T, Duppenthaler A, Zeilinger G & Gnehm HE. (2002). Congenital tuberculosis in a premature infant. Swiss Med Wkly , 132, 598-602. PMID: 12571760 DOI.

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Cite this page: Hill, M.A. (2020, July 7) Embryology Abnormal Development - Tuberculosis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Tuberculosis

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