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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2011, Number 3

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Rev Esp Med Quir 2011; 16 (3)

Management of tuberculous meningitis in immunocompetent adults

Jasso OJC, Ruiz OL, Domínguez GLE, Gutiérrez PRA, Bermúdez FF, Barragán GO, Becerril PDE, Páramo RF, Cuadros MJ

Language: Spanish
References: 10
Page: 173-176
PDF size: 256.24 Kb.


ABSTRACT

Tuberculous meningitis is secondary to rupture of a tubercle into the subarachnoid space. Its clinical presentation is usually subacute or chronic primarily affecting brain. Clinically it is accompanied by headache, intermittent fever, cranial nerve palsies (especially oculomotor), confusion, hemiparesis, lethargy, meningeal signs and sometimes seizures. We report the case of a female 23 year-old patient who was admitted in the internal medicine service with meningeal irritation, fever and behavioral changes. With study protocol (cerebrospinal fluid analysis, clinical and conventional treatment failure) was integrated the diagnosis of tuberculoma. It is emphasized that early empirical antituberculous treatment and steroids prevent the emergence of drug resistance strains and may improve the prognosis of patients.


REFERENCES

  1. Kent S, Crowe S, Yung A, Lucas C, Mijch A. Tuberculosis meningitis: A 30-year review. Clin Infect Dis 1993;17:987-994.

  2. Donald P, Schoeman J. Tuberculous meningitis. N Engl J Med 2004;351:1719-1720.

  3. Enberg M, Quezada ML, del Toro C, Fuenzalina L. Meningitis tuberculosa en adultos: análisis de 53 casos. Rev Chil Infect 2006;23:134-139.

  4. Twaites GE, Chau T, Phu N, Choung L, et al. Diagnosis of adult tuberculous meningitis by use of clinical laboratory features. Lancet 2002;360:1287-1292.

  5. Yang Z, Kong Y, Wilson F, Foxman B, et al. Identificaction of risk factors for extrapulmonary tuberculosis. Clin Infect Dis 2004;38:199-205.

  6. Organización Panamericana de la Salud. Manual para el diagnóstico bacteriológico de la tuberculosis. Parte I. Baciloscopia. OPS 2008;28.

  7. Organización Panamericana de la Salud. Manual para el diagnóstico bacteriológico de la tuberculosis. Parte II. Cultivo. OMS 2008;33-43,55-60.

  8. Berenguer J, Moreno S, Laguna F. Tuberculous meningitis in patientes infected with the human inmundeficiency virus. N Engl J Med 1992;326:668-672.

  9. Kaplan JB, Masur H, Holmes KK. Guidelines for preventing opportunistic infections among HIV infected persons. Recommendations of the US Public Health Service and the Infectious Diseases Society of America. MMWR 2002;51(RR-8):1-52.

  10. Grayeli AB, Redondo A, Salama J, Rey A. Tuberculoma of the cavernous sinus: case report. Neurosurgery 1998;42:179-181.




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