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体外受精与胚胎移植后发生急性血行播散型肺结核及结核性脑膜炎:一例报告

Acute hematogenous disseminated pulmonary tuberculosis and tuberculous meningitis following in vitro fertilization and embryo transfer: A case report.

作者信息

Li Mingyi, Yang Xuejuan, Zhou Qi, Wang Jinxiu, Wang Xicheng, Mao Lin

机构信息

School of Public Health, Kunming Medical University, No. 1168 Chunrong West Road, Yuhua Street, Chenggong District, Kunming City, Yunnan Province, China.

Yunnan Provincial Infectious Disease Hospital, 28 km from Shi 'an Highway, Yunnan Province, China.

出版信息

IDCases. 2024 Oct 28;38:e02096. doi: 10.1016/j.idcr.2024.e02096. eCollection 2024.

Abstract

With the extensive development of assisted reproductive technology, in vitro fertilization and embryo transfer (IVF-ET) have enabled successful pregnancies for some infertility patients. However, pregnancy leads to endocrine and immune function changes that result in decreased immunity, providing an opportunity for mycobacterium tuberculosis infection or reactivation. Hematogenous disseminated pulmonary tuberculosis is a dangerous complication of pregnancy after IVF-ET, which can lead to adverse outcomes. In this case report, we present a patient with normal immune function who developed hematogenous disseminated tuberculosis after IVF-ET. We retrospectively analyzed the clinical manifestations, test results and imaging findings of the patient while reviewing relevant literature. We recommend conducting genital tuberculosis screening and screening for latent tuberculosis infection before IVF-ET. Healthcare providers should maintain high vigilance for active tuberculosis during pregnancy when unexplained high fever, cough with sputum production, early vaginal bleeding occurs despite repeated broad-spectrum antibiotic treatment.

摘要

随着辅助生殖技术的广泛发展,体外受精与胚胎移植(IVF-ET)已使一些不孕患者成功受孕。然而,怀孕会导致内分泌和免疫功能变化,从而致使免疫力下降,为结核分枝杆菌感染或再激活创造了条件。血行播散型肺结核是IVF-ET术后妊娠的一种危险并发症,可导致不良后果。在本病例报告中,我们呈现了一名免疫功能正常的患者,其在IVF-ET术后发生了血行播散型肺结核。我们回顾了相关文献,同时对该患者的临床表现、检查结果及影像学表现进行了回顾性分析。我们建议在IVF-ET术前进行生殖器结核筛查及潜伏性结核感染筛查。当孕期出现不明原因的高热、咳痰咳嗽、经反复广谱抗生素治疗仍发生早期阴道出血时,医护人员应高度警惕活动性肺结核。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d55/11609473/4095c649e455/gr1.jpg

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Tuberculosis in infertility and in vitro fertilization-embryo transfer.不孕与体外受精-胚胎移植中的结核病。
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Pulmonary tuberculosis in two preterm infants conceived by fertilization.两名通过体外受精孕育的早产儿患肺结核
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本文引用的文献

1
WHO's Global Tuberculosis Report 2022.世界卫生组织《2022年全球结核病报告》。
Lancet Microbe. 2023 Jan;4(1):e20. doi: 10.1016/S2666-5247(22)00359-7. Epub 2022 Dec 12.
7
Tuberculosis (TB) in pregnancy - A review.妊娠期结核病——综述
Eur J Obstet Gynecol Reprod Biol. 2021 Apr;259:167-177. doi: 10.1016/j.ejogrb.2021.02.016. Epub 2021 Feb 19.

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