Sir.—In their article, Nemir and O'Hare1 described the importance of the recognition of congenital tuberculosis to the unborn and recently born child in the peripartum period and successfully reviewed the literature on this unusual complication of tuberculosis. However, their case report suffers from several omissions that, I feel, disqualify this case from inclusion within their review of established cases of congenital tuberculosis. Furthermore, the management of this patient, while of historical interest, was not discussed relative to current therapeutic practice and may provide inaccurate information for practitioners unfamiliar with this entity.
The criteria formulated by Bietzke2 50 years ago have been repeatedly utilized to establish the diagnosis of congenital tuberculosis in most reviews of this subject.3 Bietzke maintained that true congenital tuberculosis must be established with certainty by recovery of the organism from the lesions evident at the time of diagnosis. He also maintained that the