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A Complex Case of Pott’s Disease in Pregnancy

Published:November 11, 2022DOI:https://doi.org/10.1016/j.jogc.2022.10.013

      ABSTRACT

      Spinal tuberculosis (TB) is a rare form of extrapulmonary TB that can be clinically difficult to diagnose, particularly in pregnancy. This 24-year-old G2, P0 patient was diagnosed at 19 weeks gestation, 2 days after a protracted admission for hyperemesis gravidarum, COVID-19 infection, and unexplained transaminitis with bilateral lower limb weakness and urinary retention. She underwent emergent spinal decompression surgery with expectant management on intravenous antitubercular medication and cesarean delivery at 343 weeks gestation. Spinal tuberculosis is a difficult diagnosis, impacted by medical comorbidities, pregnancy, and diagnostic bias. This case describes successful antenatal management of spinal tuberculosis and highlights the importance of interdisciplinary care.

      RÉSUMÉ

      La tuberculose vertébrale est une rare forme de tuberculose extrapulmonaire cliniquement difficile à diagnostiquer, surtout pendant la grossesse. Cette patiente de 24 ans, G2 P0, a reçu un diagnostic à 19 SA, 2 jours après une hospitalisation prolongée pour hyperemesis gravidarum, COVID-19 et hypertransaminasémie inexpliquée avec faiblesse bilatérale des membres inférieurs et rétention urinaire. Elle a subi une intervention chirurgicale d’urgence de décompression de la colonne vertébrale avec prise en charge par expectative sous antituberculeux par voie intraveineuse et une césarienne à 34 SA + 3 j. La tuberculose vertébrale est un diagnostic difficile qui est influencé par les comorbidités, la grossesse et les biais diagnostiques. Ce cas décrit une prise en charge prénatale réussie de la tuberculose vertébrale et souligne l’importance des soins interdisciplinaires.
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