True statements concerning infants born to mothers with active tuberculosis include which of the following? a- The risk of active disease during the first year of life may approach 90% without prophylaxis b- Bacile Calmette-Guerin (BCG) vaccination of the newborn infant without evidence of active disease is not appropriate c- Future ability for tuberculin skin testing is lost after BCG administration to the newborn d- Neonatal infection is most likely acquired by aspiration of infected amniotic fluid e- Congenital infection is common despite therapy Answer: C. (Cunningham, 20/e, pp 946.) The goal of management in the infant born to a mother with active tuberculosis is prevention of early neonatal infection. Congenital infection, acquired either by a hematogenous route or by aspiration of infected amniotic fluid, is rare. Most neonatal infections are acquired by postpartum maternal contact. The risk of active disease during the first year of life may approach 50% if prophylaxis is not instituted. BCG vaccination and daily isonicotinic acid hydrazide (isoniazid, INH) therapy are both acceptable means of therapy. BCG vaccination may be easier because it requires only one injection; however, the ability to perform future tuberculin skin testing is lost.