Tuberculous meningitis in a pregnant woman: case report

Abstract

Objective: To highlight the case of a pregnant patient, with a previous diagnosis of neurotuberculosis (NT), who, after ceasing the use of medications, evolved with neurological alterations, being considered a relapse of tuberculous meningitis (TM). Based on scientific reviews, regardless of the natural history of the disease, we emphasize the importance of carrying out the appropriate treatment. Case detail: Pregnant patient, G3P1A1C, in irregular prenatal care, sought emergency care complaining of headache, hyporexia, vomiting and mental confusion. He had a previous diagnosis of TN and stopped taking medications on his own. During hospitalization, she evolved with hydrocephalus and required insertion of an external ventricular shunt (EVD), with intraoperative cerebrospinal fluid collection and resolution of the pregnancy. The diagnosis of TM recurrence was carried out jointly by clinic, imaging exams and CSF alterations, and thus, treatment was instituted. She was discharged with referral and puerperal and neurological follow-up. Final considerations: It is extremely important to guide pregnant women diagnosed with tuberculosis regarding adherence to treatment and the safety of prescribed medications. If the treatment is carried out correctly, pregnancy does not influence the course of the disease, and possible complications and maternal-fetal sequelae can be avoided.