Adverse neonatal outcome associated with maternal tuberculosis in a public tertiary centre: a retrospective cohort study.

INTRODUCTION: The aim of this study was to evaluate a group of infants born to women with tuberculosis (TB) during pregnancy to determine the neonatal morbidities and its outcomes associated with tuberculosis in pregnancy. MATERIALS AND METHODS: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score. RESULTS: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score.

Pulmonary arteriovenous malformations: A case of missed diagnosis in a neonate.

Pulmonary arteriovenous malformation (PAVM) is a congenital vascular abnormality that can cause persistent cyanosis in children. PAVMs can go undetected till adulthood; however, there have been several neonatal cases reported over the years. This case report describes a classical manifestation of a child with isolated PAVM whose diagnosis was likely missed during the neonatal period. A high level of clinical awareness of this condition is crucial as early diagnosis and appropriate treatment can prevent lifethreatening complications and mortality. Diagnosis was confirmed by computed tomography pulmonary angiography and percutaneous transcatheter embolotherapy resulted in complete resolution of symptoms.

Internal jugular vein thrombosis in a child.

Venous thrombosis is a potentially life-threatening condition with varied aetiology. First described in 1912 as a complication of peritonsillar abscess, internal jugular vein (IJV) thrombosis is a rare entity in children with very few cases reported until now. Among the leading causes of this condition are prolonged use of IJV for venous access and central venous catheterisation, acute mastoiditis and Lemierre's syndrome.1 IJV thrombosis can also occur as a complication of head and neck infections, but rarely appears as its first presentation. The clinical manifestations are often vague and ambiguous, thus requiring a high index of suspicion to diagnose IJV thrombosis. We describe here a case of internal jugular vein thrombosis (IJVT) and the management of this rare condition in an otherwise healthy 8- year-old boy. The patient was investigated thoroughly to rule out possible pathological causes of IJV thrombosis and managed holistically with a multidisciplinary team approach. Although the occurrence is rare, it should be recognised as a complication of deep neck infections in order to initiate prompt and accurate therapy.

Diagnosis of neonatal meningitis: is it time to use polymerase chain reaction?

Group B Streptococcus (GBS) is a predominant causative pathogen of neonatal meningitis that is associated with a high rate of mortality and morbidity. The establishment of antenatal screening and intrapartum chemoprophylaxis has led to a significant reduction in the incidence rate of invasive GBS disease in developed countries. However, these strategies are not routinely practiced in most developing countries. To ensure good recovery of infants affected with GBS, a prompt diagnostic strategy and appropriate therapy are essential. We highlight here the case of a preterm male infant diagnosed with early-onset of GBS meningitis diagnosed by using polymerase chain reaction (PCR) method on the cerebrospinal fluid (CSF) of the infant. Initially the pathogen was not isolated in both blood and CSF cultures as sampling was performed after the administration of antibiotics. Hence, PCR was a crucial diagnostic test in facilitating the detection of the pathogen in CSF. We believe that PCR is a potentially fast and precise diagnostic method for infection in a newborn.