The case report of the rare case of spinal tuberculosis during pregnancy was detected during the highly beneficial MRI scan. Subsequent to that a Mantoux testing and ESR was undertaken. The Mantoux test gave affirmative outcome. An aspiration of the Psoas abscess was done under local anaesthesia with local fast bacteria being segregated on the Zeil Neilson and fluorescent staining.

The line of treatment involved an administration of doses of chemotherapeutic agents like isoniazide, rifampicin, ethambutol and pyrizinamide alongside consumption of pyridoxine. Total bed rest for a period of six weeks was given to the patient with steady and slow mobilization afterwards and was hospitalized up to 8 months of pregnancy and discharged thereafter.

The patient later developed IUGR or intrauterine growth retardation along with oligohydramnios coupled with hypertension and intrahepatic cholestasis of pregnancy during 34 weeks and was once again hospitalised and conservatively managed. An elective C-section under the influence of general anaesthesia was done in 37 weeks pregnancy due to the finding of oligohydramnios and IUGR. After the child was delivered the mother was kept in supine position with the post-operative phase passing uneventfully. The patient didn’t develop spinal or neurological deformity and had good recovery with the mother and child both in fine condition.

Spinal Tuberculosis poses a host of problems with the highly grave issue being the development of paraplegia and spinal deformity. The clinical symptoms of tuberculosis during pregnancy are no different than those during the non-pregnancy state. Many experts consider that pregnancy has minimal effect on the progress or relapse of a symptomatic disease.

The above stated case report illustrates the clinical symptoms of psoas abscess formation that involved pain, limping and fever. Pain is generally centralised in the ipsilateral hip though sporadically radiating to the stomach wall, backside, thighs, knees, calves, flank and inguinal region. The chemotherapeutic agents administered during pregnancy had negligible risk of leading to birth defects.

Due to the prompt and early detection and effectual management the escalation of spinal tuberculosis was averted. A high manifestation of doubt is essential for the detection of psoas abscess that must be considered in those pregnant women that complained of back and hip pain and has a normal neurological exam. In such situations, MRI scan proves to be the best diagnostic procedure.

The likelihood of psoas muscle abscess must be taken into different analysis while probing a case of pregnancy with associated lower backache. The case report cited is an atypical case of tuberculous psoas abscess with successful mother and foetal outcome.

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