Introduction: This case study explores a unique medical presentation involving a 17-year-old primigravida female at 24 weeks gestation who arrived after experiencing witnessed convulsions at home. The following account details the patient's initial presentation, the management strategies, the outcomes, and the significant learning points around this case.

Patient Presentation: Initial examination showed a 17-year-old primigravida at 24 weeks gestation in a postictal state and elevated systolic blood pressure. Intervention commenced under the initial assumptive diagnosis of eclampsia. However, a collateral history obtained throughout the management revealed a possible secondary underlying pathology of Isoniazid toxicity with potential concomitant eclampsia.

Management and Outcome: Managing the patient necessitated addressing both the presumed eclampsia and Isoniazid toxicity simultaneously. Both the conditions were treated simultaneously rather than focusing on a single pathology. The case describes a positive outcome as both mother and infant survived.

Conclusion and Contribution: This case highlights the critical importance of considering and differentiating between multiple coexisting conditions, especially in an emergency setting where a single pathology will already explain the patient’s signs and symptoms. It further highlights the risk stratification of different treatment modalities.

Methodology
Study Design: This report presents a single case study It was completed by the treating physicians at Kalafong Hospital Emergency unit. The patient presented in 2023.

Participant Information, informed consent and ethical clearance: The participant involved in this study was a single individual. Relevant informed consent was obtained (Annexure A). Ethical clearance was also obtained (Annexure B).

Data Collection and Analysis: Data pertaining to the patient was documented and reviewed following retrospective review of the patient records.