 This case highlights a woman with brulee ulza who came in pregnant and for such a case which is a common presentation to a clinician living in an endemic community, you think of treating the patient with streptomycin and rifampicin. Streptomycin is not advisable to be given in pregnancy. More especially antibiotics should be withheld in the first trimester when fetal toxicity is most likely. WHO current guidelines do not advise streptomycin and rifampicin at all. Clarythromycin and rifampicin has been used in one patient but one has to be very cautious in giving this in a patient who is pregnant. Exition is possible when the patient presents with a noodle. In that case you could infiltrate the area with a local anesthesia like xylokine and then excise the noodle and suture the lesion. In this case streptomycin and rifampicin was withheld until the patient had a healthy baby. She came back into clinic and then we offered her antibiotic therapy streptomycin and rifampicin. The lesion then had progressed significantly and the patient did well on streptomycin and rifampicin.