Case Report: Unilateral post-tuberculosis lung destruction and massive haemoptysis in pregnancy with successful outcome

Abstract

Post-tuberculosis destroyed lung is a fatal complication of pulmonary tuberculosis which can manifest with severe life-threatening haemoptysis. Its occurrence during pregnancy is rare and challenging because of the significant risk to both the mother and the foetus. We present an unbooked 36 year old G₆P₄⁺¹ (4 alive) woman who presented with chronic cough, massive haemoptysis and multiple pregnancy (twin) at 35 week gestation. She had completed anti-tuberculosis treatment twice at and over nine years prior to presentation. On evaluation, there were clinical and radiological evidences of unilateral (right) destroyed lung but no evidence of active tuberculosis; resuscitation was with antibiotics, blood transfusion and oxygen therapy followed by an emergency caesarean delivery due to significant maternal compromise. The  symptoms resolved following antibiotic therapy and she was subsequently discharged home. Post-tuberculosis destroyed lung is a fatal uncommon condition that may present during pregnancy and requires a multi-disciplinary specialist care to ensure good maternal and foetal outcome.

Keywords: Unilateral post-tuberculosis lung destruction; Massive haemoptysis; Twin pregnancy