Abstract
Background: Tuberculosis remains a public health problem worldwide, and tuberculosis in pregnancy in particular can have effects on both mother and infant. Findings: We report a case of a 22- year-old female presenting in preterm labor at 32 weeks gestation. Her pregnancy had been complicated by hearing loss and weight loss, and at the time of delivery, she was diagnosed with tuberculous otitis media and disseminated tuberculosis. Tuberculous otitis media is a rare form of tuberculosis disease, and in this case, had consequences for mother and infant. Conclusions: Importance of suspicion for tuberculosis disease in patients presenting with atypical symptoms but epidemiologic history is emphasized.
Highlights
Tuberculosis (TB) is a common infectious disease worldwide
A 22-year-old Hispanic female with a diagnosis of preterm prolonged rupture of membranes and spontaneous vaginal delivery at 32 and 1/7 weeks was seen by the infectious disease service at our institution due to chronic otitis media
Tuberculous otitis media (TOM) accounts for only a small percentage (0.9%) of patients with chronic otitis [2]. This illness is difficult to diagnose due to multiple factors: low prevalence leading to a low index of suspicion, clinical signs that vary from the classic description, infrequent association with other systemic involvement, and false negative cultures due to the fastidious nature of Mycobacterium tuberculosis [3]
Summary
Nine million new cases are registered annually, with two thirds of these cases occurring in patients between 15 and 64 years of age [1] This is of particular concern as this age range encompasses women of childbearing age. Because of decreased immunity and atypical extrapulmonary manifestations of the disease, the diagnosis of TB may be difficult in pregnant women. While the exact risk of transmission to the fetus or newborn is unknown, a prompt diagnosis is essential to implement effective and timely antimicrobial treatment. This case report highlights dilemmas inherent in tuberculosis diagnosis, and the importance of awareness of rare forms of the disease in patients with an epidemiologic background consistent with TB disease
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