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Unusual presentation of more common disease/injury
CASE REPORT
Abdominal tuberculosis and spontaneous miscarriage
  1. Baharul Islam1,
  2. Nikita Islam2,
  3. Hudaa Mehkri1,
  4. Mai AlQaasimi1
  1. 1 Department of Pulmonology, King Abdullah Medical City, Mecca, Saudi Arabia
  2. 2 Specialized Surgical Unit, King Abdullah Medical City, Mecca, Saudi Arabia
  1. Correspondence to Dr Nikita Islam, nikitaislam{at}hotmail.com, baharulislam{at}hotmail.com

Summary

We present a case report of a 23-year-old Pakistani woman who had a second trimester spontaneous miscarriage while visiting her family in the Kingdom of Saudi Arabia. A dilatation and curettage (D&C) was done after the miscarriage. She developed sepsis and acute respiratory distress syndrome, requiring intensive care unit admission a few days after the D&C. An exploratory laparotomy was done and she was found to have a pelvic abscess. Despite adequate broad spectrum antimicrobial cover, she continued to drain a copious amount of serous fluid from the peritoneal cavity, with persistent fever and a stiff lung with difficult weaning off mechanical ventilation. Tuberculosis PCR of the peritoneal fluid came back positive. A histological finding of necrotising granuloma from the postoperative omental specimen and a positive culture from the ascitic fluid confirmed the diagnosis of Mycobacterium tuberculosis. Antituberculous treatment was started and she made a speedy recovery.

  • infections
  • obstetrics, gynaecology and fertility
  • respiratory system
  • Tb and other respiratory infections
  • adult intensive care

https://doi.org/10.1136/bcr-2017-220022

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    Footnotes

    • Contributors BI is the main author, and was responsible for the care of this patient while the patient was admitted and follow up care. BI is the main author of this case report, and conducted literature search and collected all the information on this case. NI is an associate consultant in the department of gynaecology in our hospital, and was also involved in the care of the patient while the patient was admitted, and she also contributed to writing this case report with literature search and so on. HM was an intern in BI's team when the patient was admitted, and she took keen interest in collecting all information like lab results and took further history from the patient. MAQ was also an intern and played the same role like collecting information on patient history and social background as her colleague.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.