[[妊娠期间肺结核并发症导致感染爆发的病例]。]

Kekkaku : [Tuberculosis] Pub Date : 2016-05-01
Emiko Nishikawa, Shuichi Yano, Mitsuhiro Tada, Shinichi Iwamoto, Toru Kadowaki, Masahiro Kimura, Kanako Kobayashi, Toshikazu Ikeda
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引用次数: 0

摘要

一名31岁妇女在怀孕第8周期间出现持续咳嗽,并被诊断为支气管哮喘。医生给她开了强的松龙和吸入性皮质类固醇。在怀孕28周时,她表现出体重下降、发烧、盗汗、声音嘶哑和咳嗽加剧。孕31周时,胸片上可见散点影和空洞病变。抗酸杆菌涂片试验和结核(TB)聚合酶链反应试验均呈阳性(G-8),诊断为结核。接触者追踪和筛查显示,最初患者有3名结核发病患者和18名潜伏结核感染患者,总共感染了36人。在本病例中,医生因担心伤害胎儿而不愿开具胸片,也没有开具痰或干扰素γ释放(IGRA)化验。诊断被推迟了152天,这被认为是导致疫情爆发的一个因素。妊娠患者的结核病诊断可能非常具有挑战性,因为症状最初可能归因于妊娠,而军用结核病的延迟诊断和治疗可能导致母亲和胎儿死亡。因此,为确保早期诊断和治疗,建议对有结核病症状或结核病高风险的孕妇进行胸部x线摄影和痰液及IGRA检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[[CASE OF TUBERCULOSIS COMPLICATIONS DURING PREGNANCY LEADING TO AN INFECTION OUTBREAK].]

A 31-year-old woman developed a constant cough during the 8th week of pregnancy and was diagnosed with bronchial asthma. She was prescribed prednisolone and inhaled corticosteroids. At 28 weeks of pregnancy, she showed worsening weight loss, fever, night sweats, hoarseness, and coughs. At 31 weeks of pregnancy, a scatter shadow and cavitary lesions were detected on the chest radiograph. Acid- fast bacilli smear test and tuberculosis (TB) polymerase chain reaction tests yielded positive results (G-8), and she was diagnosed with TB. Contact tracing and screening indicated 3 patients with TB onset and 18 patients with latent TB infec- tion attributed to the initial patient, who infected a total of 36 people. In the present case, physicians were reluctant to order a chest radiograph for fear of harming the fetus and did not order sputum or interferon gamma release (IGRA) assay tests either. The diagnosis was delayed by 152 days, which was considered as a factor that caused the outbreak. The diag- nosis of TB in a pregnant patient may be very challenging because symptoms may initially be ascribed to the pregnan- cy, and delayed diagnosis and treatment of military TB can lead to the death of the mother and fetus. Consequently, to ensure early diagnosis and treatment, chest radiography and sputum and IGRA tests are recommended for pregnant women who have TB symptoms or are at high risk for TB.

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