TB or not TB? Challenges in diagnosing and treating maternal and neonatal tuberculosis

We present the case of a pregnant woman who died from disseminated tuberculosis (TB), and the difficulties encountered in diagnosing TB disease in her newborn. We discuss the burden of maternal and neonatal TB and the need for a different approach, one that is not solely based on bacteriologic evidence which, in most cases, tends to be inconclusive. We also explore the difficulties physicians and national TB programs face in managing and developing effective policies for these two highly vulnerable and neglected populations. There is an urgent need for a more realistic approach to neonatal and infant TB diagnosis.