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Congenital tuberculosis in a 24 weeks gestation infant conceived after in vitro fertilization VERONICA M SAMEDI, KYLE KUREK, GREGORY RATCLIFF, AHMAD ABDULAZIZ, KAMRAN YUSUF DIVISION OF NEONATOLOGY, UNIVERSITY OF CALGARY, CALGARY , CANADA 37-year-old South –Asian woman with no significant past medical history underwent an IVF. The infertility check-up before IVF detected no abnormalities of the uterus or ovaries Her pregnancy was uneventful until 20 weeks of GA when she had spontaneous rupture of membranes. At 24 weeks of GA she presented with a generalized seizure and went to precipitous labour. Male infant was delivered by spontaneous vaginal delivery with APGAR scores on 4, 6, and 6 minutes respectively. Resuscitation of infant in case room included intubation, intermittent positive pressure ventilation with up 100% oxygen, and surfactant administration. High Frequency Oscillation Ventilation was started in the case room due to high FiO2 requirement and absent chest movement. Early diagnosis of TB was done by placental pathology Mother was admitted to ICU for seizures workup that confirmed diagnosis by growth of Mycobacterium tuberculosis in both sputum and urine culture after 15 and 17 days of incubation. Brain MRI showed innumerable small ringenhancing lesions in both cerebral and cerebellar hemispheres consistent with atypical infection : TB. Early diagnosis of TB was done by placental pathology Fetal Surface: Subchorionic necrotizing granulomatous inflammation Infant had full screening for TB including repeated AFB culture of blood, CSF, endotracheal aspirates, gastric aspirates, urine and stools, both mother and infant were started on course of isoniazid, rifampin pyrazinamide and ethambutol Day 0 of life: no specific abnormality of the pleural surfaces and lungs. Day 6 of life: Hazy reticular lung markings, reflecting worsening of lung edema on background BPD.