全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Fatal Disseminated Tuberculous Peritonitis following Spontaneous Abortion: A Case Report

DOI: 10.1155/2014/125609

Full-Text   Cite this paper   Add to My Lib

Abstract:

We describe a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. Clinical and laboratory findings were initially unremarkable. She underwent diagnostic laparoscopy which revealed numerous tiny implants on the peritoneum and viscera. Histopathology showed chronic caseating granulomas, and the tissue culture grew Mycobacterium tuberculosis. At fifth day of the antituberculous treatment multiorgan failure occurred in terms of pulmonary, hepatic, and renal insufficiency. She developed refractory metabolic acidosis with coagulopathy and pancytopenia, and she died of acute respiratory distress syndrome and septic shock on her twelfth day of hospitalization. 1. Introduction Tuberculosis (TB) is a major global health concern. The World Health Organization has declared TB a global emergency in 1994 [1]. Although it is a preventable and treatable disease, eight to ten million people develop TB every year; at least two million people die from this disease annually [2]. The incidence of the disease is 130 per 100000 people in the world and 22 per 100000 people in Turkey [3]. TB is a significant contributor to maternal mortality, with the disease being among the three leading causes of death among women aged 15–45 years [4]. Complications that have been reported in pregnancy include a higher rate of spontaneous abortion, small for date uterus, suboptimal weight gain in pregnancy, preterm labor, low birth weight, and increased neonatal mortality. Late diagnosis is an independent factor, which may increase obstetric morbidity about fourfold, while the risk of preterm labor may be increased ninefold [5]. Although the primary site for TB is lungs, one-third of patients might have extrapulmonary disease [6]. The peritoneum is one of the most common extrapulmonary sites of the disease. Disseminated or milier TB denotes all forms of progressive, widely disseminated hematogenous TB [7]. It can be primary fulminant including multiorgan system failure, septic shock, and acute respiratory distress syndrome (ARDS) with an acute onset and rapid clinical course or could be a reactivation of a latent focus, which is more likely to be subacute and chronic [7, 8]. Herein we report a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. 2. Case Presentation A 25-year-old, gravidity 3, parity 1, spontaneous abortion 1, and medical abortion with suction curettage

References

[1]  WHO, “TB: a global emergency, WHO report on the TB epidemic,” Tech. Rep. WHO/TB/1994177, World Health Organization, Geneva, Switzerland, 1994.
[2]  D. Maher, C. Dye, K. Floyd et al., “Planning to improve global health: the next decade of tuberculosis control,” Bulletin of the World Health Organization, vol. 85, no. 5, pp. 341–347, 2007.
[3]  WHO, Global Tuberculosis Control: WHO Report 2011, World Health Organization, Geneva, Switzerland, 2011.
[4]  “2010/2011 tuberculosis global facts,” World Health Organization, 2010, http://www.who.int/tb/publications/2010/factsheet_tb_2010.pdf.
[5]  P. Ormerod, “Tuberculosis in pregnancy and the puerperium,” Thorax, vol. 56, no. 6, pp. 494–499, 2001.
[6]  N. Jana, K. Vasishta, S. C. Saha, and K. Ghosh, “Obstetrical outcomes among women with extrapulmonary tuberculosis,” The New England Journal of Medicine, vol. 341, no. 9, pp. 645–649, 1999.
[7]  M. Sydow, A. Schauer, T. A. Crozier, and H. Burchardi, “Multiple organ failure in generalized disseminated tuberculosis,” Respiratory Medicine, vol. 86, no. 6, pp. 517–519, 1992.
[8]  F. Abi-Fadel and K. Gupta, “Acute respiratory distress syndrome with miliary tuberculosis: a fatal combination,” Journal of Thoracic Disease, vol. 5, no. 1, pp. 1–4, 2013.
[9]  D. Fitzgerald and D. W. Haas, “Extrapulmonary tuberculosis,” in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, G. L. Mandell, J. E. Bennett, and R. Dolin, Eds., pp. 2852–2886, Churchill Livingstone, Philadelphia, Pa, USA, 2005.
[10]  H. Jadvar, R. E. Mindelzun, E. W. Olcott, and D. B. Levitt, “Still the great mimicker: abdominal tuberculosis,” American Journal of Roentgenology, vol. 168, no. 6, pp. 1455–1460, 1997.
[11]  R. K. Dhiman, “Tuberculous peritonitis: towards a positive diagnosis,” Digestive and Liver Disease, vol. 36, no. 3, pp. 175–177, 2004.
[12]  Y.-J. Huang, L.-H. Wei, and C.-Y. Hsieh, “Clinical presentation of pelvic tuberculosis imitating ovarian malignancy,” Taiwanese Journal of Obstetrics and Gynecology, vol. 43, no. 1, pp. 29–34, 2004.
[13]  E. Vardareli, M. Kebapci, T. Saricam, ?. Pasaoglu, and M. A?ikalin, “Tuberculous peritonitis of the wet ascitic type: clinical features and diagnostic value of image-guided peritoneal biopsy,” Digestive and Liver Disease, vol. 36, no. 3, pp. 199–204, 2004.
[14]  C.-H. Wu, C.-C. ChangChien, C.-W. Tseng, H.-Y. Chang, Y.-C. Ou, and H. Lin, “Disseminated peritoneal tuberculosis simulating advanced ovarian cancer,” Taiwanese Journal of Obstetrics and Gynecology, vol. 50, no. 3, pp. 292–296, 2011.
[15]  D.-C. Ding and T.-Y. Chu, “Laparoscopic diagnosis of tuberculous peritonitis mimicking ovarian malignancy,” Taiwanese Journal of Obstetrics and Gynecology, vol. 50, no. 4, pp. 540–542, 2011.
[16]  R.-C. Bast Jr., F.-J. Xu, Y.-H. Yu, S. Barnhill, Z. Zhang, and G. B. Mills, “CA 125: the past and the future,” The International Journal of Biological Markers, vol. 13, no. 4, pp. 179–187, 1998.
[17]  T. Oge, S. S. Ozalp, O. T. Yalcin et al., “Peritoneal tuberculosis mimicking ovarian cancer,” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 162, no. 1, pp. 105–108, 2012.
[18]  J. B. Sharma, S. K. Jain, M. Pushparaj et al., “Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases,” Archives of Gynecology and Obstetrics, vol. 282, no. 6, pp. 643–648, 2010.
[19]  T. Bilgin, A. Karabay, E. Dolar, and O. H. Develio?lu, “Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases,” International Journal of Gynecological Cancer, vol. 11, no. 4, pp. 290–294, 2001.
[20]  H. L. Rieder, G. D. Kelly, A. B. Bloch, G. M. Cauthen, and D. E. Snider Jr., “Tuberculosis diagnosed at death in the United States,” Chest, vol. 100, no. 3, pp. 678–681, 1991.
[21]  L. J. Burgess, C. G. Swanepoel, and J. J. F. Taljaard, “The use of adenosine deaminase as a diagnostic tool for peritoneal tuberculosis,” Tuberculosis, vol. 81, no. 3, pp. 243–248, 2001.
[22]  M. Hensel, R. Reinartz, and R. Marnitz, “Fatal outcome of multiorgan tuberculosis with peritoneal involvement after abdominal surgery,” Medizinische Klinik, Intensivmedizin und Notfallmedizin, vol. 108, no. 4, pp. 319–322, 2013.
[23]  G. Maartens, P. A. Willcox, and S. R. Benatar, “Miliary tuberculosis: rapid diagnosis, hematologic abnormalities, and outcome in 109 treated adults,” The American Journal of Medicine, vol. 89, no. 3, pp. 291–296, 1990.
[24]  A. Mofredj, J. M. Guerin, F. Leibinger, and R. Masmoudi, “Adult respiratory distress syndrome and pancytopenia associated with miliary tuberculosis in a HIV-infected patient,” European Respiratory Journal, vol. 9, no. 12, pp. 2685–2687, 1996.
[25]  R. A. Dyer, W. A. Chappell, and P. D. Potgieter, “Adult respiratory distress syndrome associated with miliary tuberculosis,” Critical Care Medicine, vol. 13, no. 1, pp. 12–15, 1985.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133