Worapop Suthiwartnarueput, M.D.1, Poonpilas Hongmanee, M.Sc.2, Jariya Waisayarat, M.D.2 1 Department of Pathology and Forensic Medicine, Faculty of Medicine, Thammasat university, Pathumthani, Bangkok, Thailand. 2 Department of Pathology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand. Correspondence: Jariya Waisayarat, M.D. Email: email@example.com Received : 15 January 2014 Accepted : 10 March 2014
Background: Tuberculosis of the placenta is a rare condition which mainly occurs in the immunosuppressed individuals especially in acquired immune deficiency syndrome (AIDS) and hematologic malignancy9. Tuberculosis can spread to the fetus via hematogenous or cervicovaginal route and result in congenital tuberculosis. Case report: We report a case of 25-year-old primigravida, who had stage IV diffuse large B-cell lymphoma of the gastric antrum. She presented with preterm premature rupture of membranes (PPROM) and developed acute respiratory distress syndrome (ARDS) of uncertain etiology after Caesarean section. She died 12 days following delivery of acute respiratory failure. Subsequent autopsy findings revealed diffuse organizing alveolar damage in the lung, with disseminated tuberculosis of the liver, spleen, peri-pancreatic lymph nodes and placenta. The infant delivered prematurely at 31 weeks gestation with 1685 gram birth weight. Despite extensive investigations showing negative results for TB culture, the infant was diagnosed as congenital tuberculosis and treated with anti-TB drugs. At one-year follow up, the infant was in good health and showed normal development.