A 4-week-old infant born to a mother with sputum-positive pulmonary tuberculosis presents with hepatosplenomegaly, respiratory distress, and failure to thrive. Chest X-ray shows a miliary pattern. Which criterion is required to confirm congenital tuberculosis according to the Beitzke criteria?

• A Positive gastric aspirate AFB smear in the infant
• B Tuberculin skin test induration ≥10 mm in the infant
• C Caseating granuloma on infant liver biopsy
• D Confirmed tuberculous lesion PLUS involvement of hepatic portal lymph nodes or placenta ✓

Explanation

The Beitzke criteria for congenital TB require: (1) confirmed tuberculous lesion in the infant AND (2) either involvement of the hepatic portal lymph nodes, or the placenta, or a primary complex in the liver. This distinguishes congenital TB from postnatal acquisition. Gastric aspirate smear has poor sensitivity, and tuberculin testing is often falsely negative in neonates.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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