%0 Journal Article
%T Fatal Disseminated Tuberculous Peritonitis following Spontaneous Abortion: A Case Report
%A Munire Erman Akar
%A Tayfun Toptas
%A Havva Sutcu
%A Haney Durmus
%A Murat Ozekinci
%A Melike Cengiz
%A Gulgun Erdogan
%J Case Reports in Obstetrics and Gynecology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/125609
%X We describe a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. Clinical and laboratory findings were initially unremarkable. She underwent diagnostic laparoscopy which revealed numerous tiny implants on the peritoneum and viscera. Histopathology showed chronic caseating granulomas, and the tissue culture grew Mycobacterium tuberculosis. At fifth day of the antituberculous treatment multiorgan failure occurred in terms of pulmonary, hepatic, and renal insufficiency. She developed refractory metabolic acidosis with coagulopathy and pancytopenia, and she died of acute respiratory distress syndrome and septic shock on her twelfth day of hospitalization. 1. Introduction Tuberculosis (TB) is a major global health concern. The World Health Organization has declared TB a global emergency in 1994 [1]. Although it is a preventable and treatable disease, eight to ten million people develop TB every year; at least two million people die from this disease annually [2]. The incidence of the disease is 130 per 100000 people in the world and 22 per 100000 people in Turkey [3]. TB is a significant contributor to maternal mortality, with the disease being among the three leading causes of death among women aged 15¨C45 years [4]. Complications that have been reported in pregnancy include a higher rate of spontaneous abortion, small for date uterus, suboptimal weight gain in pregnancy, preterm labor, low birth weight, and increased neonatal mortality. Late diagnosis is an independent factor, which may increase obstetric morbidity about fourfold, while the risk of preterm labor may be increased ninefold [5]. Although the primary site for TB is lungs, one-third of patients might have extrapulmonary disease [6]. The peritoneum is one of the most common extrapulmonary sites of the disease. Disseminated or milier TB denotes all forms of progressive, widely disseminated hematogenous TB [7]. It can be primary fulminant including multiorgan system failure, septic shock, and acute respiratory distress syndrome (ARDS) with an acute onset and rapid clinical course or could be a reactivation of a latent focus, which is more likely to be subacute and chronic [7, 8]. Herein we report a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. 2. Case Presentation A 25-year-old, gravidity 3, parity 1, spontaneous abortion 1, and medical abortion with suction curettage
%U http://www.hindawi.com/journals/criog/2014/125609/