{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T07:50:43Z","timestamp":1766735443810,"version":"3.48.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Miliary tuberculosis (TB) in pregnancy presents unique diagnostic and therapeutic challenges due to overlapping physiological changes, imaging limitations, and fetal considerations. We describe a 42-year-old third-trimester healthcare worker who presented with prolonged fever and rapidly progressive hypoxaemia. Initial investigations were inconclusive, and imaging showed subtle reticulonodular opacities. Her condition worsened into severe ARDS, requiring emergency caesarean delivery and mechanical ventilation. Placental histopathology revealed necrotizing granulomatous inflammation, and fundoscopy identified choroidal tubercles. Mycobacterium tuberculosis was later confirmed on bronchoalveolar lavage. Anti-tubercular therapy and corticosteroids led to gradual clinical recovery and successful extubation. The neonate remained well on follow-up. This case underscores the diagnostic complexity of miliary TB in pregnancy and the value of placental pathology and fundoscopy when conventional tools fall short. With timely intervention and multidisciplinary care, even fulminant presentations can result in favourable maternal and neonatal outcomes.<\/jats:p>","DOI":"10.1093\/omcr\/omaf257","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:47:09Z","timestamp":1764679629000},"source":"Crossref","is-referenced-by-count":0,"title":["Disseminated tuberculosis complicated by ARDS in a third-trimester healthcare worker"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8883-9665","authenticated-orcid":false,"given":"Vinod","family":"Xavier","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Aster Medcity , Cheranalloor, Ernakulam District, Kochi, Kerala 682027 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishma","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Lisie Hospital, Lisie Medical and Educational Institutions , Ernakulam North, Kochi, Ernakulam District, Kerala 682018 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renji","family":"Jos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Aster Medcity , Cheranalloor, Ernakulam District, Kochi, Kerala 682027 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ge Vivin","family":"Vinister","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, MedStar Union Memorial Hospital , Baltimore, MD 21218 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"2025122602494932300_ref1","first-page":"703","article-title":"Challenges in the diagnosis & treatment of miliary tuberculosis","volume":"135","author":"Sharma","year":"2012","journal-title":"Indian J Med Res"},{"key":"2025122602494932300_ref2","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S1473-3099(17)30703-X","article-title":"The global burden of tuberculosis: results from the global burden of disease study 2015","volume":"18","author":"GBD Tuberculosis Collaborators","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2025122602494932300_ref3","first-page":"e59903","article-title":"A challenging case of Miliary tuberculosis in pregnancy","volume":"16","author":"Kumar","year":"2024","journal-title":"Cureus."},{"issue":"16","key":"2025122602494932300_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000033523","volume":"102","author":"Sari"},{"key":"2025122602494932300_ref5","first-page":"29","article-title":"Miliary tuberculosis in pregnancy in the post-Covid phase","volume":"23","author":"Choudhary","year":"2023","journal-title":"Global Journal of Medical Research"},{"key":"2025122602494932300_ref6","volume-title":"Tuberculosis Clinical Care and Treatment During Pregnancy","author":"CDC","year":"2025"},{"key":"2025122602494932300_ref7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1164\/rccm.202410-2096ST","article-title":"Official ATS\/CDC\/ERS\/IDSA clinical practice guideline: treatment of drug-susceptible tuberculosis","volume":"211","author":"Nahid","year":"2025","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/12\/omaf257\/66128337\/omaf257.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/12\/omaf257\/66128337\/omaf257.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T07:49:53Z","timestamp":1766735393000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omaf257\/8404897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":7,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,24]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omaf257","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,12]]},"article-number":"omaf257"}}