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TUBERCULOSIS IN THE PREGNANCY

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https://www.readbyqxmd.com/read/28344965/tuberculous-peritonitis-in-the-first-trimester-of-pregnancy
#1
Sukyung Jung, Nae Ri Yun, Jeong Ok Kim, Jeong Hoon Lee, Ho Yeon Kim, Eunseop Song, Byoung Ick Lee, Sung Ook Hwang, Soo Ran Choi
Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28317816/hemophagocytic-syndrome-secondary-to-tuberculosis-at-24-week-gestation
#2
Alexandra Arteaga Fernández, David Fernández de Velasco Pérez, M C Jiménez Fournier, J C Moreno Del Prado, B Paraíso Torras, M L Cañete Palomo
Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28317804/a-survey-on-undiagnosed-active-pulmonary-tuberculosis-among-pregnant-mothers-in-mekelle-and-surrounding-districts-in-tigray-ethiopia
#3
Dawit Gebreegziabiher, Kelemework Adane, Markos Abebe
OBJECTIVE/BACKGROUND: To determine the prevalence of undiagnosed active pulmonary tuberculosis (PTB) cases and sensitivity, specificity, and positive and negative predictive values of symptom combinations for undiagnosed TB infection in human immunodeficiency virus (HIV)-positive and HIV-negative pregnant mothers attending antenatal care (ANC) clinics. Mycobacterium TB and HIV are the leading causes of death among women of reproductive age worldwide. Symptom screening is the first step in the World Health Organization (WHO)-recommended TB intensified case finding algorithm for people living with HIV...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28264655/screening-in-maternity-to-ascertain-tuberculosis-status-smats-study
#4
Edward Broughton, Samson Haumba, Marianne Calnan, Sandile Ginindsa, Rosanna Jeffries, Gugu Maphalala, Sikhathele Mazibuko, Munamato Mirara, Surbhi Modi, Pasipamire Munyaradzi, Peter Preko, Batsabile Simelane
BACKGROUND: Diagnosis of tuberculosis is difficult among pregnant women because the signs and symptoms of the disease, such as fatigue, shortness of breath, sweating, cough, and mild fever are similar to some manifestations of pregnancy. It is particularly challenging among HIV-infected women as symptoms are often masked or atypical. Currently, WHO recommends a standard four-symptom screening tool for pregnant and lactating women. There is evidence from South Africa that this screening tool (which, despite complex symptomology in this population, recommends identification of patients with weight loss, fever, current cough and night sweats), may be missing true active TB cases...
March 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28219359/congenital-tuberculosis-in-an-extremely-preterm-infant-conceived-after-in-vitro-fertilization-case-report
#5
Veronica Samedi, Stephen K Field, Essa Al Awad, Gregory Ratcliffe, Kamran Yusuf
BACKGROUND: Congenital tuberculosis is a rare manifestation of tuberculosis. The diagnosis is often delayed, especially in preterm neonates because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy. CASE PRESENTATION: We report a case of congenital tuberculosis in an infant born at 24 weeks of gestation to a mother who presented with uncontrolled seizures during preterm labor. Maternal diagnosis was initially made by placental pathology, and later confirmed by isolation of Mycobacterium tuberculosis in urine, gastric aspirates and sputum...
February 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28217610/disseminated-tuberculosis-in-a-newborn-infant
#6
Tanu Sagar, Kavita Gupta, Mayuri Rani, Iqbal Rajinder Kaur
Tuberculosis (TB) remaining as one of the deadliest communicable diseases. Congenital infection by vertical transmission is rare but high neonatal mortality (up to 60%) and morbidity warrant early and accurate diagnosis of newborns suffering from TB. Intrauterine infection of tuberculosis is most commonly caused by haematogenous spread from the mother causing placental seedling. The organisms reach the fetus via the umbilical vein and the primary focus is often in the fetal liver in hematgenous spread. Another route of infection is by direct ingestion or aspiration of infected amniotic fluid if the placental caseous lesion ruptures directly into the amniotic cavity...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28184323/congenital-tuberculosis-a-newborn-case-report-with-rare-manifestation
#7
Hadi Khorsand Zak, Shahin Mafinezhad, Ali Haghbin
INTRODUCTION: Congenital tuberculosis is an infrequently encountered condition and only 300 cases were reported in the literature till 1989. There are no specific signs and symptoms pathognomonic for congenital TB, and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period. CASE PRESENTATION: In this paper we report on a case of congenital TB in a newborn who was admitted to our clinic with seizures and intraventricular hemorrhage (IVH) due to TB meningitis...
October 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28166914/role-of-anti-tubercular-treatment-for-positive-endometrial-aspirate-dna-pcr-reproductive-outcome-in-infertile-patients-in-indian-setting-a-randomized-trial
#8
A Kriplani, A Bahadur, V Kulshrestha, N Agarwal, S Singh, U B Singh
AIMS: The aim of the study was to determine the effect of anti-tubercular therapy (ATT) versus no ATT on reproductive outcome in patients with positive endometrial aspirate DNA-PCR for tuberculosis. SETTINGS AND DESIGN: Department of Obstetrics and Gynecology in collaboration with the Department of Microbiology at the All India Institute of Medical Sciences, New Delhi, India. METHODS AND MATERIALS: This prospective randomized study was conducted on 100 women in the reproductive age group with primary or secondary infertility, attending the Gynecology OPD at AIIMS...
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28027281/virologic-response-to-first-line-efavirenz-or-nevirapine-based-anti-retroviral-therapy-in-hiv-infected-african-children
#9
Adeodata Kekitiinwa, Alexander J Szubert, Moira Spyer, Richard Katuramu, Victor Musiime, Tawanda Mhute, Sabrina Bakeera-Kitaka, Oscar Senfuma, Ann Sarah Walker, Diana M Gibb
BACKGROUND: Poorer virologic response to nevirapine vs efavirenz-based antiretroviral therapy (ART) has been reported in adult systematic reviews and pediatric studies. METHODS: We compared drug discontinuation and viral load (VL) response in ART-naïve Ugandan/Zimbabwean children ≥3 years of age initiating ART with clinician-chosen nevirapine vs efavirenz in the ARROW trial. Predictors of suppression <80, <400 and <1000 copies/ml at 36, 48 and 144 weeks were identified using multivariable logistic regression with backwards elimination (p=0...
December 23, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28018449/congenital-miliary-tuberculosis-in-an-18-day-old-boy
#10
Jue Seong Lee, Chang Hoon Lim, Eunji Kim, Hyunwook Lim, Yoon Lee, Ji Tae Choung, Young Yoo
Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#11
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28011331/multi-drug-resistant-female-genital-tuberculosis-a-preliminary-report
#12
J B Sharma, Alka Kriplani, Eshani Sharma, Sangeeta Sharma, Sona Dharmendra, Sunesh Kumar, P Vanamail, S K Sharma
OBJECTIVE: Evaluation of 6 patients presenting with tubo-ovarian mass or infertility with multi drug resistant (MDR) female genital tuberculosis (FGTB). STUDY DESIGN: It was an observational study in a tertiary referral centre, India on subjects with MDR FGTB on clinical examination and investigations. All patients were given category IV drugs using kanamycin (intramuscular), levofloxacin, pyrazinamide, cycloserine, ethionamide and ethambutol (or para aminosalicylic acid [PAS] for ethambutol resistant cases) for 6 months intensive phase followed by oral levofloxacin, cycloserine, ethionamide and ethambutol (or PAS for ethambutol resistant cases) for 18 months continuation phase...
December 12, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27999684/a-perspective-of-the-diagnosis-and-management-of-congenital-tuberculosis
#13
REVIEW
Manou Irmina Saramba, Dongchi Zhao
Tuberculosis continues to be a prevalent disease in the world and a global public health issue in many countries. The disease is more complicated in pregnant women because it imperils unborn offspring and results in congenital tuberculosis later if undiagnosed and untreated. Congenital tuberculosis is rare entity and an uncommon disease along with a high mortality rate. Congenital tuberculosis, a severe clinical type of tuberculosis caused by Mycobacterium tuberculosis, is a serious and fatal disease if left untreated...
2016: Journal of Pathogens
https://www.readbyqxmd.com/read/27938369/achieving-development-goals-for-hiv-tuberculosis-and-malaria-in-sub-saharan-africa-through-integrated-antenatal-care-barriers-and-challenges
#14
EDITORIAL
Freya J I Fowkes, Bridget L Draper, Margaret Hellard, Mark Stoové
BACKGROUND: The global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health...
December 12, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27931336/risk-of-tuberculosis-during-pregnancy-in-mongolia-a-high-incidence-setting-with-low-hiv-prevalence
#15
N L Rendell, N Batjargal, N Jadambaa, C C Dobler
OBJECTIVE: To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. DESIGN: We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931054/-tb-screening-of-pregnant-women-in-accordance-with-the-german-protection-against-infection-act
#16
(no author information available yet)
Pregnant women should be tested with immune tests for tuberculosis when they undergo TB screening according to the German Infectious Diseases Protection Act. Interferon Gamma Release Assays (IGRAs) should be the priority tests used for pregnant refugees and asylum seekers, especially when migrating from high incidence countries (> 20 cases/100.000 population according to the ECDC) or when they fled from crisis regions; positive tuberculin skin tests should be veryfied with IGRA. Once immunological tests are suggesting a latent tuberculosis infection it should be considered that pregnant women have an increased risk of developing active tuberculosis with potential health threats for the unborn child...
December 2016: Pneumologie
https://www.readbyqxmd.com/read/27862893/maternal-and-perinatal-mortality-and-morbidity-associated-with-tuberculosis-during-pregnancy-and-the-postpartum-period-a-systematic-review-and-meta-analysis
#17
REVIEW
S Sobhy, Zoe Babiker, J Zamora, K S Khan, H Kunst
BACKGROUND: There is a dearth of data on the clinical features and outcomes of active tuberculosis (TB) in pregnancy. Studies have shown varied results and the relationship between TB and adverse pregnancy outcomes remains unclear. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate pregnancy outcomes associated with TB. SEARCH STRATEGY: Major databases were searched from inception until December 2015 without restrictions using the terms: 'TB', 'pregnancy', 'maternal morbidity', 'mortality' and 'perinatal morbidity', 'mortality'...
November 11, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27812086/tuberculosis-disease-during-pregnancy-and-treatment-outcomes-in-hiv-infected-and-uninfected-women-at-a-referral-hospital-in-cape-town
#18
Adrie Bekker, Hendrik S Schaaf, Heather R Draper, Magdalena Kriel, Anneke C Hesseling
BACKGROUND: Tuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings. METHODS: A prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status...
2016: PloS One
https://www.readbyqxmd.com/read/27729022/pregnancy-in-patients-with-tuberculosis-a-tbnet-cross-sectional-survey
#19
Graham H Bothamley, Cordula Ehlers, Irina Salonka, Alena Skrahina, Angels Orcau, Luigi R Codecasa, Maurizio Ferrarese, Dragica Pesut, Ivan Solovic, Andrii Dudnyk, Luis Anibarro, Claudia Denkinger, Lorenzo Guglielmetti, Inge Muylle, Marco Confalonieri
BACKGROUND: Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. METHOD: Design: A cross-sectional survey. SETTING: 13 tuberculosis clinics within different European countries and the USA. POPULATION/SAMPLE: All patients with tuberculosis seen at these clinics for a period > 1 year...
October 12, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27725039/active-tuberculosis-case-finding-among-pregnant-women-a-pilot-project-in-burkina-faso
#20
G Sulis, S Gnanou, A Roggi, A Konseimbo, P F Giorgetti, F Castelli, A Matteelli
Tuberculosis (TB) is a leading cause of death among women of childbearing age, and may be responsible for severe complications during pregnancy. Between August 2014 and March 2015, we conducted a pilot project to promote active TB case finding in antenatal care (ANC) clinics in the Central Region of Burkina Faso. Our results show very limited TB diagnostic practices and possible severe underdiagnosis of TB at ANC clinics, despite adequate screening practices. Integration of training and supervision of TB diagnosis and treatment into ANC services is required...
October 2016: International Journal of Tuberculosis and Lung Disease
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