Disseminated tuberculosis in pregnancy unknown to doctors in Western Europe case presentation: ‘part of the routine study in infertility’

Jacquemyn, Yves; Casteren, Christelle Van; Luijks, Marloes; Colpaert, Cécile

doi:10.1136/bcr-2012-006227

Cited by 10 publications

(15 citation statements)

References 8 publications

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“…Fever was the main symptom, and the time interval from fever onset to de nitive diagnosis was 2-4 weeks or more. An important nding of our study was that TB in pregnancy after IVF-ET was prone to hematogenous dissemination, which is the most serious condition of TB [3,[9][10][11][12][13][14][15][16][17]. TB dissemination may be related to latent infection, IVF-ET intervention, and immune dysregulation in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…All seven patients had primary infertility due to unilateral or bilateral oviduct obstruction, assessed by salpingography; four patients also underwent laparoscopy, with manifestations of tubal obstruction and adhesion consistent with TB, but the pathology failed to reveal features of TB. One patient had suffered from TB at the age of 16, and the local hospital administered anti-TB therapies for over 6 months at that time. The other six patients had no clinical history of TB and had not received anti-TB treatment.…”

Section: Baseline Data Of the Seven Patients With Active Tb During Prmentioning

confidence: 99%

“…We searched the published literature and summarized 37 cases of TB during pregnancy after IVF-ET [3,[9][10][11][12][13][14][15][16][17], as shown in Table 3. In 1988, Addis et al reported the rst case of miliary TB in pregnancy after IVF-ET [3].…”

Section: Literature Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Gai

Chi

Cao

et al. 2020

Preprint

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BackgroundWhile miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.MethodsData of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, Medline, and EMBASE databases.ResultsOf 62,755 enrolled women, 7137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients complicated by TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.ConclusionsTB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. The coexistence of primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction is a risk factor for TB dissemination.

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Section: Discussionmentioning

confidence: 99%

Section: Baseline Data Of the Seven Patients With Active Tb During Prmentioning

confidence: 99%

See 1 more Smart Citation

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Gai

Chi

Cao

et al. 2020

Preprint

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“…Smaller gestational sizes and increased infant morbidity and mortality were also seen from studies in South Asia and Mexico [ 33 , 36 – 38 ]. One case report documented a disseminated TB inducing a spontaneous abortion [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Untreated Active Tuberculosis in Pregnancy with Intraocular Dissemination: A Case Report and Review of the Literature

Rezai

LoBue

Adams

et al. 2015

Case Reports in Pulmonology

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Background. Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.

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“…The keywords "infertility," "in vitro fertilization and embryo transfer," "tuberculosis," and "pregnancy" were used to search for articles published from 1980 to 2019 in PubMed, MEDLINE, EMBASE, and Chinese Wanfang databases. As shown in Table 1, we summarized 37 cases of TB during pregnancy after IVF-ET [10,[16][17][18][19][20][21][22][23][24]. In 1988, Addis et al reported the rst case of miliary TB in pregnancy after IVF-ET [10], and case reports of this disease, mostly from developing countries, have occasionally been described since then [17][18][19][20][21]24].…”

Section: Literature Review Ofpatients With Tb During Pregnancy After mentioning

confidence: 99%

Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

Gai

Chi

Cao

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.Methods: Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, MEDLINE, EMBASE, and Chinese Wanfang databases.Results: Of 62,755 enrolled women, 7,137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.Conclusions: TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Physicians should not only enhance awareness about miliary TB, but also consider the occurrence of this form of TB, particularly in patients presenting with unknown fever as well as those in whom risk factors for TB reactivation such as primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction coexist.

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Disseminated tuberculosis in pregnancy unknown to doctors in Western Europe case presentation: ‘part of the routine study in infertility’

Cited by 10 publications

References 8 publications

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Untreated Active Tuberculosis in Pregnancy with Intraocular Dissemination: A Case Report and Review of the Literature

Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

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