Abstract
We report a case of a Somali refugee who presented in the second trimester of her first pregnancy with a four-week history of gradual right-sided sensomotoric hemisyndrome including facial palsy and left-sided paresis of the oculomotorius nerve causing drooping of the left eyelid and double vision. Cranial magnetic resonance imaging revealed a solitary brainstem lesion. Upon detection of hilar lymphadenopathy on chest X-ray (CXR), the diagnosis of disseminated tuberculosis with involvement of the central nervous system was confirmed by PCR and treatment induced with rifampicin, isoniazid, pyrazinamide, and ethambutol. The patient had a steady neurological improvement and a favorable pregnancy outcome.
Highlights
Upon detection of hilar lymphadenopathy on chest X-ray (CXR), the diagnosis of disseminated tuberculosis with involvement of the central nervous system was confirmed by PCR and treatment induced with rifampicin, isoniazid, pyrazinamide, and ethambutol
Tuberculosis (TB) is a contagious airborne disease caused by Mycobacterium tuberculosis that predominantly affects poor and vulnerable population groups from low- and middleincome countries that are at increased risk of TB exposure and transmission [1]
No histological investigation was obtained from the brain lesion itself, the diagnosis was made as open pulmonary tuberculosis with central dissemination and growth of a tuberculoma in the left brainstem leading to neurological deficits in this 19-year-old patient
Summary
Tuberculosis (TB) is a contagious airborne disease caused by Mycobacterium tuberculosis that predominantly affects poor and vulnerable population groups from low- and middleincome countries that are at increased risk of TB exposure and transmission [1]. TB most often affects the pulmonary system and exerts common symptoms such as cough with bloody sputum, chest pains, weakness, weight loss, fever, and night sweats. It can disseminate through the body as miliary TB and in 1% of cases it involves the central nervous system. The primary cause for MDR-TB is inappropriate treatment or incorrect use or use of poor quality anti-TB drugs. To combat this challenge, new anti-TB drugs are currently under investigation and screening programs in place to detect people who would most likely benefit from new medications. Improved rapidly and the pregnancy was carried out until term with delivery of a healthy male infant
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