Background: Tuberculosis (TB) is a common infectious disease among women of childbearing age, with the incidence of pregnancy with tuberculosis (PWT) is approximately 5-7%. PWT has a serious impact on pregnant women, fetuses and infants, and is also one of the main causes of maternal and infant mortality. Early detection, early diagnosis and early treatment often indicate the end of the disease.
Case description: The reported patient was admitted to our hospital following 2 weeks of fever plus 6 days of dyspnea during early pregnancy. An abdominal B-mode ultrasound after admission revealed intrauterine fetal death. The diagnosis of pregnancy with acute hematogenous disseminated pulmonary TB was confirmed by several examinations used in combination, such as chest CT, pathological section of the placental specimen, Bronchoalveolar lavage fluid next-generation sequencing (BALF-NGS) and so on. After anti-TB therapy with isoniazid, rifampicin, and ethambutol for 7 days, there were diffuse small nodules lesions in the lungs and mild pericardial effusion, which were partly more reduced than before. During the treatment, the patient had no adverse drug reactions. The patient was finally discharged from the hospital.
Conclusions: Clinicians should pay special attention to fever and dyspnea during pregnancy, and confirm the diagnosis of PWT through the combined use of various diagnostic tools as soon as possible. The active treatment and management of PWT, including multidrug-resistant TB, will contribute to maternal and fetal health.
Keywords: Pregnancy; acute hematogenous disseminated pulmonary tuberculosis (TB); case report; critical respiratory disease; obstetrics.