Jacquemyn Yves, Van Casteren Christelle, Luijks Marloes, Colpaert Cecile
Department of Obstetrics, UZA, Edegem, Belgium.
BMJ Case Rep. 2012 Sep 12;2012:bcr2012006227. doi: 10.1136/bcr-2012-006227.
Tuberculosis in pregnancy is possibly increasing in Western Europe due to a higher incidence in immigrant women from endemic regions. Common in recent immigrants. Diagnosis during pregnancy is delayed because the disease is more frequently extra-pulmonary with few symptoms and western doctors are no longer familiar with signs and symptoms of tuberculosis. We report the case of a 28-year-old woman presenting in the 13th week of pregnancy with vaginal bleeding, respiratory symptoms including persistent coughing and fever since 1 month. Diagnosis was delayed because of doubts on taking x-rays during pregnancy, and only 6 days after admission chest x-ray and blood-cultures led to diagnose miliary tuberculosis. Despite tuberculostatic medication expulsion of an infected fetus and placenta occurred. Histological examination of the placenta confirmed tuberculosis in the placental tissue.
由于来自结核病流行地区的移民妇女发病率较高，西欧妊娠期结核病的发病率可能正在上升。这在近期移民中很常见。妊娠期结核病的诊断往往会延迟，因为该病更多见于肺外，症状较少，而且西方医生对结核病的体征和症状不再熟悉。我们报告一例28岁女性病例，该患者在妊娠第13周出现阴道出血，伴有自1个月前开始的包括持续咳嗽和发热在内的呼吸道症状。由于对孕期进行X光检查存在疑虑，诊断被延迟，入院仅6天后，胸部X光检查和血培养确诊为粟粒性结核病。尽管使用了抗结核药物，仍出现了受感染胎儿和胎盘的排出。胎盘组织学检查证实胎盘组织存在结核。
