Skip Navigation LinksHome > September 2013 - Volume 21 - Issue 5 > Miscarriage as Initial Presentation of Tuberculosis
Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e31827cad21
Case Reports

Miscarriage as Initial Presentation of Tuberculosis

Cantres-Fonseca, Onix J. MD; Montalvo, Francisco MD; Campos-Santiago, Zulmari MD; Rodríguez-Cintrón, William MD

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Abstract

A 31-year-old woman had persistent abdominal pain, and fever, after a miscarriage at 23 weeks of gestational age. Symptoms failed to improve with antibiotics. Exploratory laparoscopy showed evidence of peritoneal and genitourinary granulomatous disease. A loculated effusion developed afterwards without previous evidence of pulmonary involvement. Thoracotomy and endometrial tissue sample showed multisensitive Mycobacterium tuberculosis infection. Her condition was diagnosed as intraperitoneal and endometrial tuberculosis with seeding to pleural space. Intraperitoneal and uterine tuberculous infection usually occurs secondary to hematogenous spread from pulmonary focus. Spread of mycobacteria from adjacent organs and subsequent pulmonary involvement is rare. In our case, documented pulmonary infection came after presentation of uterine and peritoneal infection, suggesting a secondary seeding. In addition, initial symptom was a miscarriage, which makes this an unusual case.

Copyright © 2013 by Lippincott Williams & Wilkins

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