Congenital tuberculosis in a neonate

Tuberculosis (TB) is endemic, especially in developing nations. Congenital TB is rare in neonates and more so multi drug resistant TB (MDR-TB) and not many cases have been reported. About 300 cases of congenital TB have been mentioned in the literature till 1989 with subsequent figures of 58 in 1994 and 18 more cases till 2005.1 One of the reasons for the rarity of this disease in neonates is probably the lack of clear cut differentiation between congenital and acquired cases. Though its incidence rate is low but mortality rates are high especially if infected with MDR-TB.2 We report a female neonate with congenital TB, found to be Rifampicin resistant on gene Xpert and the “congenital” cause confirmed on liver biopsy.