Missed Window, Lost Life: The Deadly Course of TB Meningitis in a Pregnant Woman

Tuberculosis meningitis is the most severe form of extrapulmonary TB. TB meningitis has an insidi-ous onset and atypical clinical manifestation. Thus, it is usually in its advanced stage when it is diag-nosed resulting in poor therapeutic efficacy and often causing severe extrapulmonary tuberculosis with high mortality. Despite the presence of different diagnostic and treatment modalities, mortality remains unacceptably high. A pregnant female patient was referred to our hospital’s emergency with suspected meningitis with a history of fever and recurrent vomiting. She was being managed conser-vatively and several tests were done (Complete Hemogram, Metabolic Profile, and Infection Panel). After various neurological investigations, CT scan of the brain revealed a lesion, suspicious of TB meningitis, though not confirmed. She gave birth to a baby girl, after which she felt drowsy. ATT was initiated 5 days post admission, on the day following her delivery. Her condition was still deteri-orating. The patient died at last, following which the final diagnosis of TB meningitis came. The following case illustrates the clinical presentation and diagnostic approach in a pregnant lady. TBM diagnosis has many intricacies though the disease is completely curable.