- Aerial Bacterial infection caused by Mycobacterium Tuberculosis; usually involves lungs but may also cause extrapulmonary infections in bones, lymph nodes, and meninges and may spread throughout bloodstream.
- Manifestations include systemic, non specific symptoms, like fatigue, malaise anorexia, weight loss, low grade fever night sweats, pulmonary signs are productive cough, pleuritic chest pain. dyspnea, and hemoptysis in advance cases.
- Diagnosed through tuberculin test: positive reaction indicates exposure to TB; most accurate is the Mantoux test or PPD (purified protein derivative) or OT (old ttuberculin from dead tubercle bacilli); significant reaction is 10 mm or more in diameter.
- Chest X-ray shows evidence of pulmonary infiltration, nodules and cavitation; Sputum exam with 3 or more specimen is needed to confirm diagnosis - most accurate is culture technique.
- Pregnant women with active TB can be treated with the drugs of choice without apparent teratogenic effects: Isoniazid (INH) ,Ethambutol Hydrochloride, and Rifampicin.
- INH is taken with Pyridoxine to prevent peripheral neuritis; Ethambutol can cause optic atrophy, and loss of green color recognition that Snellen's test is needed monthly.
- Women should increase their calcium intake to "closed off" TB lesions; these tuberculos pockets are broken down during labor while the woman is pushing.
- During post partum, infant must have prophylactic INH and is skin tested at 3 months interval and be isolated from mother with active TB, mother's on INH must not breastfeed since this leads to fetal toxicity.
TUBERCULOSIS DURING PREGNANCY
