Delayed diagnosis of intrauterine tuberculosis during mid-pregnancy leading to fetal loss and maternal disseminated tuberculosis: a case report and literature review

Atypical pregnancy symptoms lead to delayed diagnosis of tuberculosis (TB), resulting in serious harm to both the fetus and mother. We reported a patient with recurrent vaginal bleeding in mid-pregnancy accompanied by persistent low fever. Labor was induced after failed preservation treatment. The patient developed unexplained high fever postoperatively, while pathogens could not be identified by traditional detection methods. Finally, Mycobacterium tuberculosis (MTB) was detected when metagenomic next-generation sequencing (mNGS) was performed on the contents of the uterus. The patient was confirmed to have acute hematogenous disseminated pulmonary TB, tuberculous toxemia, accompanied by liver injury, and later developed into tuberculous meningitis. This case reminds the clinicians that pre-pregnancy TB screening is of great significance, and TB should be considered for pregnant patient with unexplained symptoms during pregnancy.