Tuberculosis in pregnancy with fulminant progress
20 September 2018 (online)
We describe the case of a 25 years old pregnant patient, third gravida, African at the 34th week who came to our Hospital because of nausea, pain in the right flank and fever 38,4 °c. The fetus was in breech presentation (7. Perc.), doppler of the umbilical artery was normal. Cervix length was 48 mm. Hydronephrosis grade I of the right kidney. Admission of the patient by suspected pyelonephritis for the antibiotic, analgetic and antipyretic therapy. The patient showed a remarkable recovery in the first two days. The patient complained on the fifth day about pain in the right flank, cough and fever 38,2 °c. Changing the antibiotic according to the antibiogram. The leukocytes and CRP increased. The temperature remained high despite the treatment, a blood culture was taken. Council by internal specialist: suspicion of pleural Effusion in the right lower lobe with pleurapneumonia. Because of the patients severe condition and the suspicion of sepsis we decided cesarean section on the sixth day. On the first day after surgery a chest X-ray was done and the diagnosis of tuberculosis was ascertained.
Tuberculosis must be taken in consideration in case of right hypochondriac pain in pregnancy.