Brainstem Tuberculoma in Pregnancy

Muin, D; Wagner, Katrin; Burian, Rosemarie; Maghami, Naghmeh Ghaem; Lapaire, Olav

doi:10.1155/2015/179483

Cited by 9 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Malnutrition, immunosuppressed status, and other comorbidities affect the disease course, which leads to a flare [6]. Besides that, suppression of Th1 in pregnancy leads to increased infection susceptibility and TB reactivation [7].…”

Section: Discussionmentioning

confidence: 99%

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

Vempati¹,

Samuganathan²,

Raghavan³

et al. 2022

Cureus

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Vempati¹,

Samuganathan²,

Raghavan³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Some studies revealed that the immunosuppression related to pregnancy could lead to infectious processes similar to that occurs in immunocompromised hosts ( 15 , 16 ). The T-helper 1 (Th1) proinflammatory response is suppressed during pregnancy, increasing susceptibility to new infections and reactivation of TB, but after delivery, Th1 suppression reverses, exacerbating symptoms and making women twice as likely to develop TB in the early postpartum period compared to women who had not been pregnant ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Depressive disorder with peripartum onset camouflages suspected intracranial tuberculoma

Zakia

Iskandar²

2022

Front. Psychiatry

View full text Add to dashboard Cite

BackgroundCo-occuring psychological symptoms and rare medical illnesses like intracranial tuberculoma add difficulties in diagnosing and treatment. The present report discussed a rare case of a young woman with tuberculoma and depressive disorder with peripartum onset.Case presentationThe patient was a 22-year-old woman. She underwent a cesarean section due to premature rupture of the membrane. She had developed behavioral changes for 3 months before admission and had been brought to general practitioner for several times during pregnancy. Her symptoms worsen after she underwent a cesarean section. She refused to answer doctor's and family's questions and she showed symptoms of depression. She was diagnosed with depressive disorder with peripartum onset and treated according to her diagnosis. However, she also experienced intermittent headaches which lead to suspicion that there was an organic cause for her complaints. Computed tomography (CT) was done and revealed suspected intracranial tuberculoma and meningitis. She died due to respiratory distress before she got adequate treatment for her illnesses.ConclusionThe possibility of neurocognitive disorder due to infection such as intracranial tuberculoma should be considered as an additional diagnosis (co-occuring disease) or differential diagnosis in people who develop psychiatric symptoms, especially in areas with high tuberculosis incidence.

show abstract

“…They behave like space-occupying lesions and present with signs of raised intracranial pressure, localized neurological deficits, seizures, and even behavioral problems [ 13 ]. Seizures are one of the most common symptoms occurring in up to 85% of cases along with symptoms related to elevated intracranial pressure such as headache, papilledema, and lethargy [ 33 ]. Our patient presented signs and symptoms of meningoencephalitis and space-occupying lesions: headache, vomiting, fever, altered mental status to soporous state, right hemiparesis, and generalized seizures.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy: a case report

Namani¹,

Dreshaj²,

Berisha³

2017

J Med Case Reports

View full text Add to dashboard Cite

BackgroundTuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy.Case presentationIn this case report we present a 25-year-old, Albanian, pregnant woman living in an urban area in Kosovo, who at 24 weeks of twin pregnancy manifested signs and symptoms of meningoencephalitis with decreased level of consciousness, hemiparesis, and generalized recurrent seizures. Based on medical history, origin from a region of high prevalence of tuberculosis, clinical presentation, especially neurological examination, cytobiochemical changes in cerebrospinal fluid (mild mononuclear pleocytosis with decreased level of glucose and elevated proteins), and elevated level of interferon-gamma release assay in cerebrospinal fluid, antituberculous therapy was initiated on the fourth day of admission. After 3 weeks of treatment, at 27 weeks of pregnancy, she had a preterm delivery and both twins, with low birthweight, died after 24 and 72 hours. Although findings on chest radiography were normal, brain magnetic resonance imaging showed signs of meningoencephalitis and multiple intracerebral tuberculomas, while Koch’s bacillus was isolated from urine cultures. On long-term follow-up after delivery, she was cured with no sequelae and became pregnant again without any additional complications.ConclusionsIn countries with a high prevalence of tuberculosis, screening for central nervous system tuberculosis should be considered in the differential diagnosis of meningitis in pregnancy. Cerebral imaging is essential to establish the diagnosis of brain tuberculomas in such a case of suspected tuberculous meningoencephalitis during pregnancy.

show abstract

Brainstem Tuberculoma in Pregnancy

Cited by 9 publications

References 10 publications

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

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

Case report: Depressive disorder with peripartum onset camouflages suspected intracranial tuberculoma

Tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy: a case report

Contact Info

Product

Resources

About