Rare Clinical Presentation of Tuberculous Meningitis: A Case Report

Tan, Jian Liang; Nordin, Sudzilla; Besari, Alwi Muhd

doi:10.21315/mjms2017.24.5.14

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…The seizures can be either acute symptomatic or unprovoked seizures. The cause of these seizures is mainly the inflammation of the brain, nerve damage, and activation of glial cells (13,14). This patient also showed a subacute infarction in the temporal lobe, probably due to vasculitis and appropriated with the semiology of the patient's focal to bilateral motor onset tonic clonic seizures.…”

Section: Discussionmentioning

confidence: 80%

Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19

et al. 2022

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: Tuberculous meningoencephalitis (TBM) is the most severe, life-threatening form of tuberculosis that contributes to as much as 5% of cases of extrapulmonary tuberculosis. Emerging at the end of 2019, COVID-19 has been shown to affect various organs, including the brain. In this case report, a 21-year-old woman diagnosed with TBM, being in the intensive phase of tuberculous therapy, came with dysphagia and dysphonia as new complaints felt one day before admission accompanied by a positive meningeal sign, diplopia, and cephalgia, which became heavier after previously getting better. Cough and fever followed this complaint two days before admission. About the laboratory results, the PCR was positive for COVID-19, and CT scans showed increased leptomeningeal enhancement when compared with CT scan one month earlier. The patient received intravenous dexamethasone, anti-tuberculosis drugs, phenytoin, aspirin, oseltamivir, and hydroxychloroquine. The patient died four days after being hospitalized due to respiratory failure. This case report shows the coinfection of COVID-19 and TBM resulting in a poor tuberculosis treatment response and outcome.

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Section: Discussionmentioning

confidence: 80%

Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19

et al. 2022

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“…CSF should be acquired as soon as possible for analysis. (8)(9)(10)(11)(12)(13)(14)(15)(16) The most commonly found infectious pathogens are commensal organisms of the external auditory canal and nasopharynx in patients diagnosed with post-neurosurgical meningitis however the likelihood of nosocomial infection is recommended not to be overlooked. Aspiration of stomach contents is prevalent in individuals who have had a head injury, and it is typically worsened by bacterial super-infection.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Post-Neurosurgical Nosocomial Bacterial Meningitis in Adults: a retrospective Cross-Sectional Study

Shah¹,

Shaikh²,

Mehmood³

2022

PJMHS

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Aim: To analyze the characteristics of Post-neurosurgical nosocomial bacterial meningitis in adults Study design: A retrospective cross-sectional study Place and duration: Riyadh Care Hospital/ National Care Hospital, from July 2005 to June 2010 then 2013 to 2018. Methodology: Over ten years, sixty-two patients above the age of 16 years who suffered from Post-neurosurgical nosocomial bacterial meningitis were evaluated by collecting clinical data. The cases were divided into two categories, the first one from July 2007 to June 2012 and second one from August 2013 to July 2018. Results: Among the 62 patients, there were 43 males and 19 females with post-neurosurgical nosocomial bacterial meningitis. It was recorded in the first group that the percentage of post-neurosurgical nosocomial meningitis in all culture-proven adult bacterial meningitis was 12 percent and for the second group it was seen to be 27 percent. The most constant clinical characteristics were fever and gradual consciousness disruption, which may be related to various postoperative neurosurgery issues. The most prevalent pathogens were recorded to be pseudomonas aeruginosa, staphylococcus aureus, coagulase-negative staphylococcus, Acinetobacter baumannii, and lastly, Escherichia coli. During the second era, there was a rise in polymicrobial illnesses and multi antibiotic resistance. Mortality was 22% in the first group of the study and 36% in the second group of the study. Conclusion: The selection of appropriate empirical antibiotics is complex and is necessary to be guided by knowledge of the comparative ratio of multiple diseases as well as the rising prevalence of resistant strains. To increase the likelihood of survival, early diagnosis is suggested with optimal antibiotic selection based on in vitro susceptibility testing, epidemiologic patterns, and lastly, metabolic derangement treatment to be advised and required. Keywords: Bacterial Meningitis, adults, post-neurosurgery

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“…However, this patients CSF finding did not match the typical findings but there were increased levels of neutrophil count (81.4) and MRI whole spine showed suggestive of TB meningitis. 14,15 The patient was treated with ceftriaxone intravenously Q12 hourly, in addition injection Thiamine and Neurobion forte was given as Vitamin supplement.…”

Section: Discussionmentioning

confidence: 99%

Retroviral Disease in Immunocompromised Patient Causing Varicella Encephalitis and TB meningitis –A Case Report

Bn¹,

Ganesh²,

Javvaji³

2021

IJOPP

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The occurrence of opportunistic infection is largely seen in immunocompromised patients. Varicella infection is one such infection caused by Varicella Zoster Virus (VZV) -a human neurotropic virus which primarily presents as varicella or chickenpox and remains in dormant stage which reactivates showing as the leading cause for viral encephalitis. This case demonstrates a 32 years male patient who was presented with fever, chills, urinary retention, giddiness and vascular lesions on body. The patient was diagnosed as varicella zoster infection with the evidence of Polymerase chain reaction (PCR) of Cerebrospinal fluid (CSF) and started with ACYCLOVIR injection 500 mg. Later based on magnetic resonance imaging (MRI) scan results patient was found to have Tuberculosis meningitis and CD4 count human retrovirus (HIV) report reviled HIV. Gradually patient started developing rashes on genitals diagnosed as Verruca Vulgaris. The patient was on symptomatic therapy with anti tuberculoid (AKT 4 kit) with plan to start Anti-retroviral therapy (ART) after 2weeks.

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Rare Clinical Presentation of Tuberculous Meningitis: A Case Report

Abstract: Conclusion: This is a rare clinical manifestation of Tuberculous meningitis that demonstrates the importance of recognising and initiating the treatment early to reduce disabilities and improve clinical outcome.

Cited by 7 publications

References 9 publications

Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19

Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19

Characteristics of Post-Neurosurgical Nosocomial Bacterial Meningitis in Adults: a retrospective Cross-Sectional Study

Retroviral Disease in Immunocompromised Patient Causing Varicella Encephalitis and TB meningitis –A Case Report

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