Acute Miliary Tuberculosis and Pelvic Tuberculosis after In vitro Fertilization

• 作者: Fan Li-Juan Liu Shan Ma Ting-Ting Qi Yun
• 来源期刊: 生殖与发育医学（英文）
• 关键词: Acute Miliary Tuberculosis In vitro Fertilization Pelvic Tuberculosis Pregnancy
• 年，卷（期）: 2020,（2）
• 所属期刊栏目: Case Report
• 页码范围: 123-127
• 页数: 5页
• 语种: 中文
• DOI: 10.4103/2096-2924.288020

摘要

Nearly one-fourth of the world’s population is infected with Mycobacterium tuberculosis (MTB). Female genital tuberculosis (TB) is a common cause of infertility in both developing and undeveloped countries. Furthermore, assisted reproduction treatments and pregnancy potentially increase the risk of TB infection and reactivation. In this study, we present the case of a 28-year-old infertile female without a history of TB who developed an acute miliary TB and pelvic TB after in vitro fertilization-embryo transfer (IVF-ET). Elevated serum estrogen levels during controlled ovarian hyperstimulation and T-lymphocyte function inhibition during pregnancy are the risk factors for MTB infection and reactivation. In her 7 th week of gestation, the patient developed fever and spontaneously aborted. Her chest computed tomography images revealed classical miliary TB. Uterine curettage tissue and vaginal secretion samples as well as Gene X-pert MTB/rifampicin (RIF) and TB-RNA test results were positive for MTB. Histological examination of the uterine curettage tissue confirmed the diagnosis of endometrial TB. Treatment with isoniazid, RIF, pyrazinamide, amikacin, and levofloxacin was selected based on the patient’s diagnosis, complications, and test results. Currently, the patient is undergoing anti-TB treatment, and her condition is stable. It is important to rule out the presence of TB in infertile patients before performing IVF-ET to avoid TB dissemination during pregnancy.