Received by the Editorial Office: 08.06.2026
Accepted for publication: 26.06.2026
Published online: 30.06.2026
UDC: 616-002.5
DOI: 10.26212/2227-1937.2026.44.74.010
MANAGEMENT FEATURES OF A PREGNANT WOMAN WITH TUBERCULOSIS AND EPILEPSY: A CASE REPORT AND MULTIDISCIPLINARY APPROACH
Tashimova S.A.¹,3, Nuranova N.T.¹, Duysenov A.Zh.¹, Tazhikhanov R.N.², Kapanova K.A.², Ibragimova A.G.³, Seidaliyeva S.K.³
¹ Shymkent Campus of Akhmet Yassawi International Kazakh-Turkish University, Shymkent, Kazakhstan.
² State Communal Enterprise on the Right of Economic Management “Regional Phthisiopulmonology Center” of Turkestan Region, Shymkent, Kazakhstan.
³ JSC “South Kazakhstan Medical Academy”, Department of Pharmacology, Pharmacotherapy and Clinical Pharmacology, Shymkent, Kazakhstan.
Introduction: Tuberculosis diagnosed during pregnancy in a woman with epilepsy is an uncommon but clinically important comorbid condition. Neurological deterioration, infectious intoxication, and pregnancy-related physiological changes may overlap, delay diagnosis, and complicate treatment selection. Management therefore requires simultaneous control of tuberculosis activity, seizure prevention, and continuous assessment of obstetric and fetal risks.
Aim: To describe the clinical course, diagnostic work-up, and treatment strategy for disseminated tuberculosis detected during pregnancy in a patient with epilepsy, based on a single clinical case.
Materials and methods: A retrospective review of the inpatient medical record of a 28-year-old pregnant patient was performed. The analysis included medical history, clinical status at admission, laboratory and instrumental findings, specialist consultations, treatment decisions, and maternal-fetal outcomes during follow-up.
Results: The patient was admitted at 24 weeks of gestation after repeated epileptic seizures with impaired consciousness and sopor. Chest computed tomography and GeneXpert testing of bronchoalveolar lavage supported the diagnosis of bilateral disseminated pulmonary tuberculosis in the phase of destruction. Tuberculous meningitis was considered because of meningeal signs, but cerebrospinal fluid testing did not confirm it. Treatment included second-line anti-tuberculosis drugs, anticonvulsant, dehydration, symptomatic, and supportive therapy. Clinical improvement was reflected by recovery of consciousness, fewer seizures, and partial radiological regression of pulmonary lesions. At 33 weeks of gestation, emergency cesarean section was performed due to fetal distress, intrauterine growth restriction, oligohydramnios, and impaired uteroplacental blood flow. The premature newborn’s condition subsequently stabilized.
Discussion: The case emphasizes that neurological worsening in a pregnant woman with epilepsy should not automatically be attributed to epilepsy alone. Previous tuberculosis required prompt exclusion of tuberculous meningitis and reassessment of pulmonary disease activity. Interpretation of GeneXpert positivity despite negative microscopy, use of second-line anti-tuberculosis treatment during pregnancy, and close fetal surveillance were the main clinical decision points.
Conclusion: Epilepsy, pregnancy, and disseminated tuberculosis in the same patient represent a rare high-risk clinical scenario. Early recognition of tuberculosis activity, careful differential diagnosis of meningeal manifestations, attention to drug interactions, and coordinated multidisciplinary care are essential for improving maternal and perinatal outcomes.
Keywords: epilepsy, disseminated tuberculosis, pregnancy, drug-resistant tuberculosis, GeneXpert MTB/RIF, coordinated multidisciplinary management, perinatal risk, cesarean section, clinical case.
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