http://dx.doi.org/10.18203/2320-1770.ijrcog20150127 Volume 4 · Issue 3 Page 911 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Singh S et al. Int J Reprod Contracept Obstet Gynecol. 2015 Jun;4(3):911-914 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report A rare case of CNS tuberculosis with pregnancy Sanjay Singh 1 *, Tony Jose 1 , Puneet Saxena 2 INTRODUCTION Tuberculosis is a common infection in developing countries. Only 1% of these cases develop CNS tuberculosis. TB meningitis is the most devastating form of extra-pulmonary tuberculosis with very high mortality and morbidity. The initial clinical manifestation of TB meningitis may mimic normal pregnancy symptoms leading to delay in diagnosis resulting in complications to the mother as well as to the fetus. 1-5 High index of suspicion is thus a key factor in its timely diagnosis. Timely diagnosis and appropriate institution of treatment resulted in favorable pregnancy outcome. CASE REPORT A 23 years old G2P1L1 lady, educated up to fifth standard, a home maker of low socioeconomic status, was admitted at 33 weeks Period Of Gestation (POG), with complaints of 5-6 episodes of vomiting per day and headache of fifteen days duration. She had been having fever with chills and rigor for three days and photophobia for one day. She had been feeling lethargic and her appetite had gone down for the last one month. There was no history of cough, chest pain, increased frequency of micturition, dysuria, head injury or convulsion. She didn’t offer any complaints of pain abdomen or foul smelling vaginal discharge. She had perceived adequate fetal movements. Her last menstrual period was on 10 June 2014 making her expected date of delivery 17 March 2015. Her earlier cycles were regular. She had a full term normal vaginal delivery 3 years ago. She was a booked case and the index pregnancy was a spontaneous conception, confirmed by first trimester sonography. Her blood group was A positive. Sugar profile was normal. Screening test for hepatitis B, syphilis and HIV were negative. Second trimester sonography confirmed the dating and ruled out any obvious congenital anomalies. She was diagnosed to have Tuberculous Meningitis (TBM) one year back for which she was put on Anti Tubercular Treatment (ATT). However she defaulted and stopped ATT after two months against medical advice. 1 Department of Obstetrics & Gynaecology, Armed Forces Medical College, Pune-411040, Maharashtra, India 2 Department of Respiratory Medicine, Armed Forces Medical College, Pune-411040, Maharashtra, India Received: 31 March 2015 Accepted: 09 May 2015 *Correspondence: Dr. Sanjay Singh, E-mail: drsanjaysingh@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Whereas pelvic tuberculosis leading to infertility is quite common in female population of developing countries, Central Nervous System (CNS) tuberculosis (TB) with pregnancy is a rare entity. Most of the information on this subject is based on sporadic case reports only. Most of the earlier reports suggest very high adverse outcome of CNS Tuberculosis in pregnancy. We are presenting a case of CNS Tuberculosis which was diagnosed timely and managed appropriately in our institute with a favourable outcome, thus highlighting the importance of early diagnosis and treatment. Keywords: Tuberculosis, Central nervous system, Meningitis, Pregnancy, ATT DOI: 10.18203/2320-1770.ijrcog20150127