Linda S Efferen1. 1. Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York 11042, USA. lefferen@lij.edu
Abstract
PURPOSE OF REVIEW: To provide a summary of the diagnostic and therapeutic challenges, including risks and benefits of treatment, of tuberculosis and latent Mycobacterium tuberculosis infection during pregnancy. RECENT FINDINGS: Recent developments in diagnostic options have added to the armamentarium of tests available to diagnose latent Mycobacterium tuberculosis infection. Increasing evidence supports the potential for successful treatment of multidrug-resistant tuberculosis during pregnancy with good maternal and neonatal outcomes. The impact of genital tuberculosis on the outcome of assisted in-vitro fertilization techniques is noted. SUMMARY: The diagnostic approach for the evaluation of tuberculosis or latent Mycobacterium tuberculosis infection is unchanged by pregnancy, and includes clinical suspicion of disease, tuberculin skin testing or interferon-gamma-based assay, chest radiography with appropriate shielding when indicated, and acid-fast bacillus stain and culture of clinical material. For patients with active tuberculosis, therapy should be initiated as soon as the diagnosis is established. Initiation of treatment for latent infection during pregnancy should be considered based on the risk for progression to active disease.
PURPOSE OF REVIEW: To provide a summary of the diagnostic and therapeutic challenges, including risks and benefits of treatment, of tuberculosis and latent Mycobacterium tuberculosis infection during pregnancy. RECENT FINDINGS: Recent developments in diagnostic options have added to the armamentarium of tests available to diagnose latent Mycobacterium tuberculosis infection. Increasing evidence supports the potential for successful treatment of multidrug-resistant tuberculosis during pregnancy with good maternal and neonatal outcomes. The impact of genital tuberculosis on the outcome of assisted in-vitro fertilization techniques is noted. SUMMARY: The diagnostic approach for the evaluation of tuberculosis or latent Mycobacterium tuberculosis infection is unchanged by pregnancy, and includes clinical suspicion of disease, tuberculin skin testing or interferon-gamma-based assay, chest radiography with appropriate shielding when indicated, and acid-fast bacillus stain and culture of clinical material. For patients with active tuberculosis, therapy should be initiated as soon as the diagnosis is established. Initiation of treatment for latent infection during pregnancy should be considered based on the risk for progression to active disease.