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.
Keywords
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References
- Fact sheet: tuberculosis.(Available at:)https://www.who.int/news-room/fact-sheets/detail/tuberculosisDate accessed: June 6, 2021
- Canadian tuberculosis standards. 7th ed.(Available at:)
- Tuberculosis in Canada - summary 2015.Can Commun Dis Rep. 2017; 43: 77-82
- Tuberculosis of the spine (Pott disease) presenting as ‘compression fractures’.Spinal Cord. 2002; 40: 604-608
- Spinal tuberculosis: a diagnostic and management challenge.J Neurosurg. 1995; 83: 243-247
- Tuberculosis in pregnancy: the challenges for South Asian countries.J Obstet Gynaecol Res. 2012; 38: 1125-1136
- Antepartum surgical management of Pott paraplegia along with maintenance of pregnancy during second trimester.Eur Spine J. 2016; 25: 1064-1069
- Clinical approach and surgical strategy for spinal disease in pregnant women.Spine (Phila Pa 1976). 2008; 33: E614-E619
Article info
Publication history
Published online: November 11, 2022
Accepted:
October 18,
2022
Received:
July 28,
2022
Footnotes
Disclosures: The authors declare they have nothing to disclose.
Each author has indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
