August 1986

Diagnostic Criteria of Congenital Tuberculosis-Reply

Author Affiliations

Department of Pediatrics New York University Medical Center 550 First Ave New York, NY 10016

Am J Dis Child. 1986;140(8):740-741. doi:10.1001/archpedi.1986.02140220021012

In Reply.—With interest, we reviewed Dr Corrall's letter. Two major areas of question appeared: namely, (1) the diagnostic criteria of congenital tuberculosis utilizing the Bietzke1 criteria, and (2) the failure to discuss fully current therapy. Regarding Bietzke's criteria, we refer to the article by Hageman et al,2 which suggested that these criteria are no longer applicable. Nevertheless, we did comment in the article3 that the hematogenous route for infection was apparently the mode in this patient. The subcutaneous nodule, culture-positive, was apparently infected by the hematogenous route. We did state that the infant was separated immediately at birth from the mother. Although it was not mentioned in the article, there was no father or other household member, and there were no other nursery infections from the patient's hospital. As we noted, the prevention of nursery contagion is important. Referring to the time of incubation before the

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