A Case of Tuberculous Meningitis in a Pregnant Woman with Miliary Pulmonary Tuberculosis: Challenges in Diagnosis and Management

Gulnura Turdumambetova; Elnura Usubalieva; Kunduz Toktorgazieva; Ramilia Akhmetova; Aiymgul Duishekeeva; Bakyt Myrzaliev; Muratbek Ahmatov; Ruchika Garg; Altynai  Zhumabekova

Gulnura Turdumambetova Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Elnura Usubalieva Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Kunduz Toktorgazieva National Centre of Phthisiology, Ministry of the Health of the Kyrgyz Republic, Bishkek, Kyrgyz Republic
Ramilia Akhmetova Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Aiymgul Duishekeeva Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Bakyt Myrzaliev Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Muratbek Ahmatov Department of Phthisiology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
Ruchika Garg Department of Obstetrics and Gynaecology, SN Medical College, Agra, Uttar Pradesh, India
Altynai Zhumabekova Honorary International Faculty, AJ Research Centre, AJ Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India

Keywords: Tuberculous Meningitis, Pregnancy, Amniotic Fluid Leakage, Miliary Pulmonary Tuberculosis, Magnetic Resonance Imaging

Abstract

The case report describes a 34-year-old female patient who was diagnosed with tuberculous meningitis and miliary pulmonary tuberculosis (TB) during her 16th week of pregnancy. The patient presented with symptoms such as vomiting, severe debilitation, lethargy, and loss of appetite. Chest radiography revealed pulmonary TB with a disseminated pattern of small nodules throughout the lungs. Brain magnetic resonance imaging showed meningoencephalitis with lacunar infarctions in the right hypothalamic area and left internal capsule. The patient was diagnosed with tuberculous meningitis causing alternating Weber syndrome and brain coma. The patient received standard anti- TB treatment with rifampicin, isoniazid, pyrazinamide, and ethambutol for two months, followed by four months of rifampicin and isoniazid. An emergency caesarean section was performed, but the premature male and female infants did not survive. The patient was stable and showed no signs of deterioration.

How to cite this article:
Turdumambetova G, Usubalieva E, Toktorgazieva K, Akhmetova R, Duishekeeva A, Myrzaliev B, Ahmatov M, Garg R, Zhumabekova A. A Case of Tuberculous Meningitis in a Pregnant Woman with Miliary Pulmonary Tuberculosis: Challenges in Diagnosis and Management. J Commun Dis. 2024;56(2):96-100.

DOI: https://doi.org/10.24321/0019.5138.202438

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