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Disseminated tuberculosis after pregnancy progressed to paradoxical response to the treatment: report of two cases.
Shinohara, Tsutomu; Kagawa, Kozo; Okano, Yoshio; Sawada, Toru; Kobayashi, Tooru; Takikawa, Masaya; Iwahara, Yoshihito; Ogushi, Fumitaka.
Afiliación
  • Shinohara T; Department of Clinical Investigation, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan. shinoharat@kochi2.hosp.go.jp.
  • Kagawa K; Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Okano Y; Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Sawada T; Division of Thoracic Surgery, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Kobayashi T; Division of Orthopaedic Surgery, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Takikawa M; Division of Obstetrics and Gynecology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Iwahara Y; Division of Hematology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
  • Ogushi F; Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
BMC Infect Dis ; 16: 284, 2016 06 13.
Article en En | MEDLINE | ID: mdl-27297079
BACKGROUND: Early postpartum women are more likely to develop tuberculosis than nonpregnant women mainly due to immune reconstitution after delivery. Paradoxical response (PR) during antituberculosis treatment also arises via recovery from immunosuppression. However, no study focused on PR during antituberculosis treatment in a postpartum patient has been reported. CASE PRESENTATION: We present two sequential cases (Patient 1: 26-year-old; Patient 2: 29-year-old) of postpartum tuberculosis with pulmonary and extrapulmonary lesions (Patient 1: peritonitis; Patient 2: psoas abscess secondary to spondylitis). Both cases progressed to PR (worsening of pre-existing lung infiltrations (Patients 1, 2) and new contralateral effusion (Patient 2)) in a relatively short time after initiation of treatment (Patient 1: 1 week; Patient 2: 3 weeks), suggesting that immune modulations during pregnancy and delivery may contribute to the pathogenesis of both disseminated tuberculosis and its PR. The pulmonary lesions and effusion of both cases gradually improved without change of chemotherapy regimen. CONCLUSION: Physicians should recognize PR in tuberculosis patients with postpartum and then evaluate treatment efficacy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección Puerperal / Peritonitis Tuberculosa / Tuberculosis Pulmonar / Tuberculosis de la Columna Vertebral / Absceso del Psoas / Antituberculosos Tipo de estudio: Etiology_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2016 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección Puerperal / Peritonitis Tuberculosa / Tuberculosis Pulmonar / Tuberculosis de la Columna Vertebral / Absceso del Psoas / Antituberculosos Tipo de estudio: Etiology_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2016 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido