Tuberculosis (TB) remains a major public health threat in Bangladesh. Pregnant women face a heightened risk of contracting TB, which can lead to a more severe clinical trajectory and severely compromise both maternal and fetal outcomes. Approximately two-thirds of pregnant women with TB are asymptomatic, largely due to latent infection. Diagnosis is difficult because constitutional TB symptoms mimic normal physiological changes during pregnancy, radio-imaging options are restricted, and invasive diagnostic procedures are often delayed. Here we report a case of tuberculosisin a pregnant woman who presented with a short history of breathlessness and cough with low-grade fever, and progressive breathlessness that swiftly evolved into severe respiratory distress. A chest X-ray confirmed a right-sided pleural effusion. Although sputum smears were negative for Acid-Fast Bacilli (AFB) and GeneXpert, pleural fluid thoracocentesis revealed marked lymphocytosis (98%) and elevated adenosine deaminase (ADA) levels. This critical finding secured the diagnosis of tuberculous pleural effusion (TPE) on the 6th day of the puerperium. Tuberculous pleuritis during pregnancy is a rare, life-threatening condition that presents significant diagnostic hurdles due to its non-specific and delayed presentation. However, in regions with a high TB burden, clinicians must maintain a high index of clinical suspicion for tuberculosis in any pregnant woman presenting with unexplained pleural effusion.

July 2026; Vol. 20(2):003.  DOI: https://doi.org/10.55010/imcjms.20.012

*Correspondence: Shahana Shermin, Assistant Professor, Dept. of Obstetrics & Gynaecology, Ibrahim Medical College & BIRDEM General Hospital, 1/A Segunbagicha Road, Dhaka-1000, Bangladesh. E-mail: shahana.shermin@yahoo.com.

© 2026 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License(CC BY 4.0)