Multi-Drug Resistant Tuberculous Meningitis in a Pregnant Woman

Tuberculous meningitis (TBM) is the most fatal form of the Mycobacterium tuberculosis infection. Its diagnosis remains difficult due to poor suspicion of the disease especially in the case of pregnancy. We bring to your attention a 27-year-old pregnant woman who came to the emergency department with headache and nausea. With high clinical suspicion and early treatment with Meropenem 3x2 gram, Levofloxacin 2 x 500 mg, Amoxicillin Clavulanate 3 x 1 gram, Ethambutol 1 x 25 mg/kg body weight, Pyrazinamide 1 x 15 mg/kg body weight and 0.4 mg/kg body weight Dexamethasone resulted in patient’s recovery. The immune tolerant state of pregnancy and its relationship with the M. tuberculosis infections needs further research. Clinicians need to think about the TBM and other tuberculosis infections for prompt diagnosis and early treatment.