In July, 2013, a 25-year-old postpartum woman (case-patient) died and was subsequently diagnosed as having been infected with tuberculosis (TB). She had been admitted briefly at one Clark County hospital (Hospital A) for premature rupture of membranes then transferred to a second Clark County hospital (Hospital B) where she delivered extremely preterm-gestation twins (twin A and twin B) in May, 2013. She had been ill to varying degrees prior to and after the birth of her twins. Her condition worsened, and she was eventually admitted to Hospital B and later transferred to a Southern California hospital for a higher level of care shortly before her death. On autopsy, the diagnosis of TB meningitis was made. Review of hospital chart notes and discussions with family members was inconclusive as to whether or not the case-patient was likely to have been contagious during her illness. Twin A died in June. Twin B remained hospitalized in Hospital B’s Level III neonatal intensive care unit (NICU A). As soon as the hospital learned of the case-patient’s diagnosis, Twin B was moved to a negative-pressure isolation room per hospital infection control policies and tested for TB. Twin B’s test results were subsequently positive for TB. Despite having been started on TB treatment when the diagnosis of TB made, Twin B died in August.