Multidrug-resistant tuberculosis in pregnancy: case report and review of the literature.

Author(s): Lessnau KD, Qarah S

Affiliation(s): Weill Medical School, Cornell University, New York, NY, USA. KLessnau@pol.net

Publication date & source: 2003-03, Chest., 123(3):953-6.

Publication type: Review

A woman at 23 weeks' gestation was treated with rifampin, isoniazid, and ethambutol for cavitary tuberculosis (TB). She did not respond within 3 weeks, and multidrug-resistant (MDR) TB was suspected. Direct plating on susceptibility media was performed immediately. Treatment was initiated with IV capreomycin, levofloxacin, para-aminosalicylic acid, pyrazinamide, cycloserine, and high-dose vitamin B(6) at 26 weeks' gestation. The patient delivered vaginally at week 35. The newborn was not infected. Following delivery, ethionamide was added as a sixth drug, and levofloxacin was replaced with moxifloxacin. The patient's sputum became smear-negative and culture-negative for TB. All reported cases of MDR-TB during pregnancy are reviewed.