Abstract: 　Objective　To explore the clinical features of congenital tuberculosis. Method　The clinical data of congenital tuberculosis in 20 infants were retrospectively analyzed. Results　The mothers of 19 infants (95.0%) were found to have tuberculosis in pregnancy and only five (25%) were diagnosed with tuberculosis pre-partum. The median age at onset was 26 days (1-90 days). Among the 20 infants, cough was a symptom in 15 infants, fever in 14 infants, respiratory distress in 12 infants, hepatosplenomegaly in 9 infants, and abdominal distension in 7 infants. Acid-fast bacillus smear or tuberculosis culture was positive in 10 infants, and T-SPOT was positive in 9 infants. Chest imaging findings were abnormal in all 20 infants, including extensive nodules and patchy shadows in 12 infants, diffuse miliary nodules in 6 infants, and sporadic patchy shadows in right lung in 2 infants. Abdominal ultrasonography and/or CT were performed in 16 infants, and multiple nodules in liver and spleen were found in 7 infants, lymph node enlargement in abdominal cavity in 6 infants, and ascites in 6 infants. The main sites of tuberculosis infection were lung (in all 20 cases), liver (in 7 cases), spleen (in 7 cases), peritoneal cavity (in 8 cases) and brain (in 7 cases). Because 3 infants were in critical condition, their families asked to terminate the diagnosis and treatment, and they did not receive antituberculosis drugs. In the remaining 17 infants who were treated with anti-tuberculosis drugs, 10 infants were discharged after their condition improved, and 7 infants gave up treatment after their condition worsened. Conclusion　Congenital tuberculosis is often characterized by systemic disseminated infection. The early diagnosis rate can be improved by combination of maternal tuberculosis history during pregnancy, repeatedly searching for etiological evidence, imaging examination, T-SPOT and other auxiliary examinations. Early and standard anti-tuberculosis treatment is expected to reduce the mortality rate.

Key words: tuberculosis;　clinical manifestation;　infant