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Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome

Central nervous system tuberculosis (CNS-TB) is rarely suspected in pregnancy because its clinical presentation may masquerade other common conditions in pregnancy, such as eclampsia. In high tuberculosis endemic areas, CNS-TB should be suspected with a high degree of suspicion among unimmunized and...

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Autores principales: Vempati, Roopeessh, Samuganathan, Periyaiyadever, Raghavan, Prithvi, Rajpal, Shreyaa, Guralwar, Chinmay, Padamati, Bhavani, Tango, Tamara, Sahu, Sweta, Bingi, Thrilok Chander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773629/
https://www.ncbi.nlm.nih.gov/pubmed/36569713
http://dx.doi.org/10.7759/cureus.31772
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author Vempati, Roopeessh
Samuganathan, Periyaiyadever
Raghavan, Prithvi
Rajpal, Shreyaa
Guralwar, Chinmay
Padamati, Bhavani
Tango, Tamara
Sahu, Sweta
Bingi, Thrilok Chander
author_facet Vempati, Roopeessh
Samuganathan, Periyaiyadever
Raghavan, Prithvi
Rajpal, Shreyaa
Guralwar, Chinmay
Padamati, Bhavani
Tango, Tamara
Sahu, Sweta
Bingi, Thrilok Chander
author_sort Vempati, Roopeessh
collection PubMed
description Central nervous system tuberculosis (CNS-TB) is rarely suspected in pregnancy because its clinical presentation may masquerade other common conditions in pregnancy, such as eclampsia. In high tuberculosis endemic areas, CNS-TB should be suspected with a high degree of suspicion among unimmunized and immunocompromised individuals. We hereby report a case of a 32-year-old pregnant woman conceived by in vitro fertilization due to tubal blockage causing infertility, probably due to chronic infection, who presented with a history of multiple seizure episodes without a history of similar complaints outside this pregnancy. Obstetric examination revealed a gravid uterus larger than the corresponding gestational age, and an antenatal scan confirmed dichorionic diamniotic twins with the first twin in the breech and the second twin in the cephalic presentation. Magnetic resonance imaging of the brain revealed multiple nodular lesions of varying sizes that were isointense on T1-weighted imaging and hypointense on T2-weighted imaging in multiple regions of the brain, which suggest tuberculomas. A preterm cesarean section was performed at 31 weeks gestational age due to preterm rupture of membranes. We report this case to enlighten the physicians in diagnosing seizures causing intracranial tuberculoma in pregnant women and utilizing the role of imaging in diagnosis.
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spelling pubmed-97736292022-12-23 Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome Vempati, Roopeessh Samuganathan, Periyaiyadever Raghavan, Prithvi Rajpal, Shreyaa Guralwar, Chinmay Padamati, Bhavani Tango, Tamara Sahu, Sweta Bingi, Thrilok Chander Cureus Internal Medicine Central nervous system tuberculosis (CNS-TB) is rarely suspected in pregnancy because its clinical presentation may masquerade other common conditions in pregnancy, such as eclampsia. In high tuberculosis endemic areas, CNS-TB should be suspected with a high degree of suspicion among unimmunized and immunocompromised individuals. We hereby report a case of a 32-year-old pregnant woman conceived by in vitro fertilization due to tubal blockage causing infertility, probably due to chronic infection, who presented with a history of multiple seizure episodes without a history of similar complaints outside this pregnancy. Obstetric examination revealed a gravid uterus larger than the corresponding gestational age, and an antenatal scan confirmed dichorionic diamniotic twins with the first twin in the breech and the second twin in the cephalic presentation. Magnetic resonance imaging of the brain revealed multiple nodular lesions of varying sizes that were isointense on T1-weighted imaging and hypointense on T2-weighted imaging in multiple regions of the brain, which suggest tuberculomas. A preterm cesarean section was performed at 31 weeks gestational age due to preterm rupture of membranes. We report this case to enlighten the physicians in diagnosing seizures causing intracranial tuberculoma in pregnant women and utilizing the role of imaging in diagnosis. Cureus 2022-11-22 /pmc/articles/PMC9773629/ /pubmed/36569713 http://dx.doi.org/10.7759/cureus.31772 Text en Copyright © 2022, Vempati et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Vempati, Roopeessh
Samuganathan, Periyaiyadever
Raghavan, Prithvi
Rajpal, Shreyaa
Guralwar, Chinmay
Padamati, Bhavani
Tango, Tamara
Sahu, Sweta
Bingi, Thrilok Chander
Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title_full Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title_fullStr Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title_full_unstemmed Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title_short Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome
title_sort intracranial tuberculoma in a pregnant lady: a hitherto unknown case and a successful outcome
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773629/
https://www.ncbi.nlm.nih.gov/pubmed/36569713
http://dx.doi.org/10.7759/cureus.31772
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