Awoman is hiv +ve.s we has delivered 4days back.postpartum her tuberculin test positive. hence further screened for kochs. On USG she is having abdominal lymphadenopathy with splenic microabscesses.Physician says that it is a case of abdominal kochs.sputum is negative. CHEST X-RAY IS NOT SUGGESTIVE OFpulmonary kochs. Physician says that though it is not a open case. it can be disseminated kochs. ANDsputum report can be false negative. Should we start prophylactic antitubercular therapy to the baby considering it as a case of contact morher is going to breast fed the baby. We have similar case ie similar finding but whose afb culture came positive 3 weeks later Check out the answer

If a pregnant woman with active pulmonary tuberculosis is sputum negative during the last three months of gestation, the risk to infant is negligible. However since the mother is HIV infected and has abdominal kochs with splenic microabscesses, then she may have occult pulmonary TB that may be not seen on the Xray chest in an immunosuppressed state. In such a situation, it would be better to screen the child for TB by doing an Xray chest and a Mantoux test and if suggestive of TB, AKT would be needed. If negative, one may consider INH prophylaxis for the child in view of strong suspicion.