COVID-19 has created one of the world's worst pandemics and is associated with various life-threatening complications and infections, possibly due to various internal and external host factors. Cytomegalovirus (CMV) coinfection is one of those infections. We present a challenging case of severe COVID-19 infection managed in our ICU care facility with concomitant CMV infection. We aim to highlight the significance of early diagnosis and prompt management for a better outcome.
Introduction
Neurotuberculosis comprises around 6% of systemic tuberculosis. It targets a younger population, and it often leads to severe neurological complications or death.
Case report
We report a young gentleman with a clinically defined tuberculous meningitis (TBM) and multiple neurological complication associated with TBM occurring simultaneously. This includes hydrocephalus requiring a ventriculoperitoneal shunt, vasculitic infarcts, cranial nerve palsies, TB granuloma and cerebral venous thrombosis. The cerebrospinal fluid polymerase chain reaction for tuberculosis as well as cultures remained negative repeatedly. The patient was treated with anti-tuberculous medication in addition to steroids based on validated scoring systems suggestive of TBM and made a good recovery.
Conclusion
This report highlights the different complication seen with TBM and the importance of using clinical criteria to guide management plan particularly when cultures are negative.
COVID 19 has created one of the world’s worst pandemics and is
associated with various life-threatening complications, such as
Cytomegalovirus (CMV) co-infection. We present a life-threatening CMV
viremia co-infection in a none-immunocompromised COVID 19 patient to
highlight our management approach and a comprehensive literature review.
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