Disseminated tuberculosis in a pregnant immunocompetent healthcare worker

Abstract

Health care workers (HCWs) have an increased risk of Mycobacterium Tuberculosis (TB) infection compared to general population. Pregnancy suppresses the Lymphocyte T-helper 1 (Th1) pro-inflammatory response. Frequent and consecutive pregnancies may also promote TB infection or reactivation of latent TB. But there is still no evidence of certain risk of severe disseminated infection. A 35-year-old pregnant woman, working as a laboratory officer, presented with fever, general weakness then acute respiratory failure. Miliary lung nodules were noted on chest X-ray. Under the impression of miliary tuberculosis, anti TB medication was administered. Likelihood of This diagnosis was due to her occupation, exposition to Mycobacterium Tuberculosis, clinical and radiologic findings. CT scan revealed cerebro-meningeal, pulmonary, splenic and ganglionary TB. The patient was treated successfully with ordinary anti TB combination regimen. Delivery and post partum was without complication. Cases of severe TB in an otherwise healthy pregnant woman are rare. This is an occupational disease to prevent.

Keywords

• disseminated tuberculosis
• health care worker
• occupational
• pregnancy