Diagnosis dan penatalaksanaan tuberkulosis sistem saraf pusat

Abstract

Introduction: Central nervous system (CNS) tuberculous are the most dangerous form of extrapulmonary TB. CNS tuberculous can present as meningoencephalitis, intracranial tuberculomas, and vasculitis. CNS tuberculous accounts for about 1% of all TB cases and is associated with high mortality. Tuberculous meningoencephalitis commonly presents with classic symptoms of fever, headache, meningism (neck stiffness), seizures as well as focal neurologic deficits, and altered consciousness. The diagnosis and treatment of CNS tuberculosis is still a formidable clinical challenge. Case report: Patient presented with fever, Pendahuluan: Tuberkulosis sistem saraf pusat (SSP) adalah TB ekstrapulmoner yang paling berbahaya. Penyakit ini meliputi meningoensefalitis, tuberkuloma intrakranial, dan vaskulitis. Prevalensi tuberkulosis SSP sekitar 1% dari semua kasus TB dan berhubungan dengan kematian yang tinggi. Meningoensefalitis tuberkulosis biasanya muncul dengan gejala demam, sakit kepala, meningismus, kejang, defisit neurologis fokal, dan penurunan kesadaran. Diagnosis dan pengobatan tuberkulosis SSP masih merupakan tantangan klinis yang berat. Laporan kasus: Seorang pasien datang dengan headache, meningismus, convulsion, and decreased consciousness. CT scan showed cerebral tuberculoma in the left parietal lobe. Examination gene-Xpert of the cerebrospinal fluid showed Mycobacterium tuberculosis. The patient was given category 1 of antituberculosis drugs. Conclusion: CNS tuberculosis has non-specific symptoms, difficult diagnosis, and high mortality. In this case report, the diagnosis of CNS tuberculosis was established based on the presence of Mycobacterium tuberculosis on the CSF molecular rapid test examination, and a CT scan of the head with contrast found cerebral tuberculoma. gejala demam, sakit kepala, meningismus, kejang, dan penurunan kesadaran. CT scan menunjukkan tuberkuloma serebral di lobus parietal kiri. Pemeriksaan tes cepat molekuler cairan serebrospinal menunjukkan Mycobacterium tuberculosis. Pasien diberikan obat anti tuberkulosis kategori 1. Simpulan: Tuberkulosis SSP memiliki gejala yang tidak spesifik, diagnosis sulit, dan mortalitas tinggi. Pada kasus diagnosa tuberkulosis SSP ditegakkan berdasarkan adanya Mycobacterium tuberculosis pada pemeriksaan tes cepat molekular CSF, dan CT scan kepala dengan kontras dijumpai tuberkuloma serebral.