Tuberculous meningitis in early pregnancy mimicking hyperemesis gravidarum: A diagnostic challenge

Jana, Narayan; Rakshit, Bibek Mohan; Trivedi, Geetika

doi:10.1080/01443610802249267

Cited by 4 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our experience, misinterpretation of initial symptoms of meningitis with other infectious diseases can cause diagnostic delay resulting in dangerous complications, such as cranial nerve palsies and paraplegia. In these women, prolonged debility due to paraplegia and concurrent infections can also adversely affect the course of pregnancy and perinatal outcome 11 …”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, women in these countries are most profoundly affected by TB, which is the third leading cause of death among women of reproductive age 4 . As TB mostly occurs in young women, many infected women are diagnosed having the disease during pregnancy, while others become pregnant during TB medication; and more importantly, a proportion remains undiagnosed and suffers worse maternal and perinatal consequences 5–17 . A recent postmortem analysis of maternal deaths highlights that infection, including TB, is an important contributor to maternal death in India 17…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, there is a sense of complacency among obstetricians regarding the benign course of both disease and pregnancy among these women suffering from TB. However, several recent reports from diverse countries have tempered this false notion, and suggested that TB remains a potential danger for mother, fetus and newborn 7–13,21,22 . Furthermore, resurgence of TB in immunocompromised mothers with HIV infection, and multidrug‐resistant TB and extreme‐drug‐resistant TB have added new dimensions to an already complex issue 23,24 .…”

Section: Introductionmentioning

confidence: 99%

“…4 As TB mostly occurs in young women, many infected women are diagnosed having the disease during pregnancy, while others become pregnant during TB medication; and more importantly, a proportion remains undiagnosed and suffers worse maternal and perinatal consequences. [5][6][7][8][9][10][11][12][13][14][15][16][17] A recent postmortem analysis of maternal deaths highlights that infection, including TB, is an important contributor to maternal death in India. 17 Current literature on the prevalence of TB among pregnant women in developing countries like India is not available.…”

Section: Introductionmentioning

confidence: 99%

“…However, several recent reports from diverse countries have tempered this false notion, and suggested that TB remains a potential danger for mother, fetus and newborn. [7][8][9][10][11][12][13]21,22 Furthermore, resurgence of TB in immunocompromised mothers with HIV infection, and multidrug-resistant TB and extreme-drug-resistant TB have added new dimensions to an already complex issue. 23,24 In this review, we plan to assemble current evidence regarding implications and management of maternal TB, especially in the context of South Asian countries.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Tuberculosis in pregnancy: The challenges for South Asian countries

Jana

Barik²,

Arora

et al. 2012

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Abstractj og_1856 1125..1136Aim: Despite tuberculosis (TB) being a global problem, maternal TB remains an unrecognized and underestimated tragedy, especially in South Asian countries. Therefore, we performed a non-systematic review regarding implications of maternal TB on obstetric and perinatal outcomes in the South Asian context. Material and Methods:We reviewed original studies, both descriptive and analytical, that originated from South Asian countries following an electronic search supplemented by a manual search. Although relevant studies from developed countries were reviewed, they were not included in the tabulation process because those studies had different socioeconomic/epidemiological background. Results: Diagnosis of TB is often delayed during pregnancy, because of its non-specific symptoms, and overlapping presentation with other infectious diseases. Poverty, undernutrition, lack of social support and poor health infrastructure along with complications of TB and need for prolonged medications lead to increased maternal morbidity and mortality. Maternal TB in general (except lymphadenitis), is associated with an increased risk of small-for-gestational age, preterm and low-birthweight neonates, and high perinatal mortality. These adverse perinatal outcomes are even more pronounced in women with advanced disease, late diagnosis, and incomplete or irregular drug treatment. There could be a synergy of TB, socioeconomic and nutritional factors, which might have contributed to adverse perinatal effects, especially in low-income countries. Conclusions: As active TB poses grave maternal and perinatal risks, early, appropriate and adequate anti-TB treatment is a mainstay for successful pregnancy outcome. The current knowledge gaps in perinatal implications of maternal TB can be addressed by a multicenter comparative cohort study.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Tuberculosis in pregnancy: The challenges for South Asian countries

Jana

Barik²,

Arora

et al. 2012

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

Pregnancy-Related Tuberculous Meningitis and Immune Reconstitution Inflammatory Syndrome: A Case Series and Systematic Review

Pastick

Kagimu

Dobbin

et al. 2022

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Tuberculosis is a leading cause of death among women of reproductive age. However, tuberculous meningitis, the most severe form of extrapulmonary tuberculosis, is rarely discussed in pregnancy despite this being a unique period of immune modulation which may predispose women to active disease. Methods We identified and described cases of tuberculous meningitis among pregnant or postpartum women screened during meningitis clinical trials in Uganda from 2018-2022. We conducted a systematic literature review via PubMED/MEDLINE and EMBASE for all English language publications from 1970 to July 10, 2022, to identify additional cases. Results We identified 8 cases of pregnancy-related tuberculous meningitis in Ugandan women living with HIV and 40 additional cases via systematic literature review (none HIV-positive). Of all combined cases, 50% (24/48) were diagnosed postpartum; 50% (24/48) had initial onset during pregnancy, of which 38% (9/24) had worsening of symptoms or disease relapse following pregnancy cessation. Diagnosis was missed or delayed in 33% (16/48) of cases. For those with known outcomes, maternal mortality was 23% (11/48) and fetal/neonatal mortality was 30% (13/44). Of maternal survivors, 30% (11/37) had residual neurologic deficits. Conclusion The true incidence of tuberculous meningitis in pregnancy or the postpartum period is unclear but likely underappreciated. To date, nearly all published cases have occurred in HIV-negative, or otherwise immunocompetent women. Given the well-described physiological immunosuppression during pregnancy and subsequent reconstitution postpartum, physicians must be aware of tuberculous meningitis and pregnancy-related immune reconstitution inflammatory syndrome, especially in high burden tuberculosis countries and in women living with HIV.

show abstract

Current World Literature

2009

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Tuberculous meningitis in early pregnancy mimicking hyperemesis gravidarum: A diagnostic challenge

Cited by 4 publications

References 7 publications

Tuberculosis in pregnancy: The challenges for South Asian countries

Tuberculosis in pregnancy: The challenges for South Asian countries

Pregnancy-Related Tuberculous Meningitis and Immune Reconstitution Inflammatory Syndrome: A Case Series and Systematic Review

Current World Literature

Contact Info

Product

Resources

About