Management of four pregnant women with multidrug-resistant tuberculosis

This case series describes the medical management of four pregnant women wi th active multidrug-resistant tuberculosis. None of the four patients were infected with human immunodeficiency virus. Three patients had disease due to multidrug-resistant Mycobacterium tuberculosis, and one had disease due to multidrug-resistant Mycobacterium bovis. Only one patient (patient 3) be gan retreatment during pregnancy, because her organism was susceptible to t hree antituberculosis drugs that were considered nontoxic to the fetus. Des pite concern over teratogenicity of the second-line antituberculosis medica tions, careful timing of treatment initiation resulted in clinical cure for the mothers, despite some complications due to chronic tuberculosis and/or therapy. All infants were born healthy and remain free of tuberculosis. Pr egnancy and multidrug-resistant tuberculosis need not be a public health di saster, as both conditions can be managed concurrently and successfully.