This review discusses the recent literature (2006–2020) about the epidemiology, clinical presentation, diagnosis, and management of infants with congenital or perinatal tuberculosis (TB). While the incidence of childhood TB is declining in the United States and worldwide, many case reports describe how clinical suspicion for neonatal TB is raised only if an ill-appearing neonate does not improve with broad-spectrum antibiotics. Furthermore, the delay in initiating appropriate anti-TB therapy often results in the need for significant cardiopulmonary support and/or an increase in mortality. This review summarizes important clinical indications in the maternal and newborn history, the evaluation of an infant with possible TB exposure, and step-by-step recommendations for the treatment and follow-up of infants with TB.

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