Tuberculous Meningitis: A Rare Case Report
DOI:
https://doi.org/10.5281/zenodo.17155901Keywords:
Tuberculous meningitis, postpartum, miliary tuberculosisAbstract
Tuberculous meningitis (TBM) is a rare but severe form of tuberculosis, often leading to high morbidity and mortality when diagnosis is delayed. A 27-year-old postpartum female presented with headache, fever, nausea, and vomiting. She had recent weight loss and episodes of confusion. Examination revealed lethargy and nuchal rigidity. MRI showed multiple ring-enhancing lesions with vasogenic edema, and chest radiography demonstrated micronodular infiltrates suggestive of miliary tuberculosis. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, elevated protein, and low glucose. Acid-fast bacilli and TB PCR confirmed the diagnosis. The patient was treated with antituberculous therapy and monitored by a multidisciplinary team. This case underlines the importance of considering TBM in postpartum patients with atypical meningitis symptoms and highlights the role of early diagnosis and treatment in improving outcomes.
References
1. Thwaites, G.E., R. van Toorn, and J. Schoeman, Tuberculous meningitis: more questions, still too few answers. Lancet Neurol, 2013. 12(10): p. 999-1010. 10.1016/S1474-4422(13)70168-6 PMID: 10.1016/S1474-4422(13)70168-6,
2. Marais, S., G. Thwaites, J.F. Schoeman, M.E. Torok, U.K. Misra, K. Prasad, et al., Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis, 2010. 10(11): p. 803-12. 10.1016/S1473-3099(10)70138-9 PMID: 10.1016/S1473-3099(10)70138-9,
3. Rock, R.B., M. Olin, C.A. Baker, T.W. Molitor, and P.K. Peterson, Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev, 2008. 21(2): p. 243-61, table of contents. 10.1128/CMR.00042-07 PMID: PMC2292571
4. Jain, S.K., D.M. Tobin, E.W. Tucker, V. Venketaraman, A.A. Ordonez, L. Jayashankar, et al., Tuberculous meningitis: a roadmap for advancing basic and translational research. Nat Immunol, 2018. 19(6): p. 521-525. 10.1038/s41590-018-0119-x PMID: PMC6089350
5. Prasad, K., M.B. Singh, and H. Ryan, Corticosteroids for managing tuberculous meningitis. Cochrane Database Syst Rev, 2016. 4(4): p. CD002244. 10.1002/14651858.CD002244.pub4 PMID: PMC4916936 independently conducted 'Risk of bias' assessments and data entry and interpretation with the CIDG Co-ordinating Editor, Paul Garner.
6. Bernaerts, A., F.M. Vanhoenacker, P.M. Parizel, J.W. Van Goethem, R. Van Altena, A. Laridon, et al., Tuberculosis of the central nervous system: overview of neuroradiological findings. Eur Radiol, 2003. 13(8): p. 1876-90. 10.1007/s00330-002-1608-7 PMID: 10.1007/s00330-002-1608-7,
7. Cresswell, F.V., L. Tugume, N.C. Bahr, R. Kwizera, A.S. Bangdiwala, A.K. Musubire, et al., Xpert MTB/RIF Ultra for the diagnosis of HIV-associated tuberculous meningitis: a prospective validation study. Lancet Infect Dis, 2020. 20(3): p. 308-317. 10.1016/S1473-3099(19)30550-X PMID: PMC7045085
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