title: Untreated Active Tuberculosis in Pregnancy with Intraocular Dissemination: A Case Report and Review of the Literature.
abstract: Background. Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
authors.forename: Shadi
authors.identifier: 0000-0001-8498-565X
authors.initials: S
authors.lastname: Rezai
authors.affiliation: St. George's University, School of Medicine, Grenada.
authors.forename: Stephen
authors.initials: S
authors.lastname: LoBue
authors.affiliation: St. George's University, School of Medicine, Grenada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Adams
authors.affiliation: St. George's University, School of Medicine, Grenada.
authors.forename: Yewande
authors.initials: Y
authors.lastname: Oladipo
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
authors.forename: Ramses
authors.initials: R
authors.lastname: Posso
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Mapp
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Santiago
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
authors.forename: Manisha
authors.initials: M
authors.lastname: Jain
authors.affiliation: Coney Island Hospital, Pulmonary Medicine, Brooklyn, NY 11235, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Marino
authors.affiliation: Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA ; Cornell Medical College, NY 10065, USA.
authors.forename: Cassandra E
authors.initials: CE
authors.lastname: Henderson