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妊娠合并肺结核导致大量咯血及单侧肺完全萎陷,母婴结局良好:一例病例报告

Massive hemoptysis and complete unilateral lung collapse in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome: a case report.

作者信息

Masukume Gwinyai, Sengurayi Elton, Moyo Phinot, Feliu Julio, Gandanhamo Danboy, Ndebele Wedu, Ngwenya Solwayo, Gwini Rudo

机构信息

Department of Obstetrics and Gynaecology, Mpilo Central Hospital, Bulawayo, Zimbabwe.

出版信息

BMC Res Notes. 2013 Aug 22;6:335. doi: 10.1186/1756-0500-6-335.

Abstract

BACKGROUND

We report an extremely rare case of massive hemoptysis and complete left-sided lung collapse in pregnancy due to pulmonary tuberculosis in a health care worker with good maternal and fetal outcome.

CASE PRESENTATION

A 33-year-old human immuno deficiency virus seronegative African health care worker in her fourth pregnancy with two previous second trimester miscarriages and an apparently healthy daughter from her third pregnancy presented coughing up copious amounts of blood at 18 weeks and two days of gestation. She had a cervical suture in situ for presumed cervical weakness. Computed tomography of her chest showed complete collapse of the left lung; subsequent bronchoscopy was apparently normal. Her serum β-human chorionic gonadotropin, tests for autoimmune disease and echocardiography were all normal. Her lung re-inflated spontaneously. Sputum for acid alcohol fast bacilli was positive; our patient was commenced on anti-tuberculosis medication and pyridoxine. At 41 weeks and three days of pregnancy our patient went into spontaneous labor and delivered a live born female baby weighing 2.6 kg with APGAR scores of nine and 10 at one and five minutes respectively. She and her baby are apparently doing well about 10 months after delivery.

CONCLUSION

It is possible to have massive hemoptysis and complete unilateral lung collapse with spontaneous resolution in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome.

摘要

背景

我们报告了一例极为罕见的病例,一名医护人员在孕期因肺结核出现大量咯血及左侧肺完全萎陷,母婴结局良好。

病例介绍

一名33岁的非洲医护人员,人类免疫缺陷病毒血清学阴性,第四次怀孕,前两次怀孕均在孕中期流产,第三次怀孕有一个健康的女儿。她在妊娠18周零2天时出现大量咯血。因推测宫颈机能不全,她有一个宫颈缝线。胸部计算机断层扫描显示左肺完全萎陷;随后的支气管镜检查结果基本正常。她的血清β-人绒毛膜促性腺激素、自身免疫性疾病检测及超声心动图检查均正常。她的肺自行复张。痰涂片抗酸杆菌阳性;患者开始接受抗结核药物及吡哆醇治疗。妊娠41周零3天时,患者自然临产,分娩出一名体重2.6千克的活产女婴,1分钟和5分钟时的阿氏评分分别为9分和10分。产后约10个月,她和她的宝宝情况明显良好。

结论

孕期因肺结核出现大量咯血及单侧肺完全萎陷并自行缓解,且母婴结局良好是有可能的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a9a/3765411/ecb8aeb6b195/1756-0500-6-335-1.jpg

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