Sherer David M, Osho Joseph A, Zinn Harry, Demetus Spiro, Huang Jennifer, Temkin Sarah, Abulafia Ovadia
Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Medical Center, Brooklyn, New York 11203-2098, USA.
Am J Perinatol. 2005 Oct;22(7):383-5. doi: 10.1055/s-2005-872600.
Disseminated extrapulmonary tuberculosis is an uncommon complication of pregnancy. We present a 26-year-old multiparous immigrant from Haiti who was admitted following an extramural preterm delivery. Marked ascites was confirmed by computerized tomography, which also revealed a thickened greater omentum. These findings were considered suggestive of advanced ovarian carcinoma, although extrapulmonary tuberculosis was also considered despite negative tuberculin skin test screening. Image-guided omental biopsy demonstrated caseating granulomas substantiating the diagnosis of abdominal tuberculosis, which was later confirmed by cultures. The patient responded well to antituberculosis medications. This case describes the unusual peripartum presentation of abdominal tuberculosis simulating advanced ovarian carcinoma, and demonstrates the importance of considering extrapulmonary tuberculosis when encountering ascites and omental thickening during pregnancy despite negative tuberculin skin test screening.
播散性肺外结核是妊娠的一种罕见并发症。我们报告一名26岁来自海地的经产妇移民，她在院外早产后来院就诊。计算机断层扫描证实有大量腹水，还显示大网膜增厚。这些发现被认为提示晚期卵巢癌，尽管结核菌素皮肤试验筛查为阴性，但也考虑了肺外结核。影像引导下的大网膜活检显示干酪样肉芽肿，证实为腹部结核，后来培养结果也证实了这一诊断。患者对抗结核药物反应良好。该病例描述了腹部结核在围产期不寻常的表现，类似晚期卵巢癌，并表明在妊娠期间遇到腹水和大网膜增厚时，尽管结核菌素皮肤试验筛查为阴性，考虑肺外结核的重要性。
