Congenital miliary tuberculosis.

A case of a premature baby who had the classical problems associated with congenital tuberculosis and presented a difficult diagnostic problem is described. Diagnosis was ultimately confirmed by liver biopsy. Treatment was initially with isoniazid alone, followed 2 weeks later by isoniazid and rifampicin. Isoniazid was replaced by ethambutol when an isoniazid-resistant culture was obtained. The baby responded extremely well to therapy and, at 2-year follow-up, was growing satisfactorily without any sequelae. To my knowledge, this is the first case of congenital tuberculosis with a miliary spread to be seen, treated and followed up in the developing world, where tuberculosis is prevalent.