A Case Report on Complicated Tuberculous Meningitis

Abstract

Tuberculous meningitis (TBM) is associated with significant complications of central nervous system. It is accompanied by nonspecific and heterogeneous clinical symptoms. We focused on the significance of early diagnosis and prompt treatment. We describe a case of TBM in a 19-year-old Asian female. She had a progressive motor weakness with no sensory findings. She was started on antituberculous therapy. Her magnetic resonance imaging (MRI) contrast of dorsolumbar spine showed syringomyelia. Her culture and sensitivity for Mycobacterium tuberculosis (MTB) came negative. She was given a therapeutic trial of quinolones and Steroids. She had an uneventful recovery and was followed up for the past one year.

Analysis of Tuberculosis Meningitis Pathogenesis, Diagnosis, and Treatment

“…The traditional treatment for pulmonary TB has been standardized to the RIPE [rifampin (RIF), isoniazid (INH), pyrazinamide, ethambutol) therapy for 2 months followed by RI (rifampin, isoniazid) for 10 months [ 20 , 23 , 37 , 38 , 39 ]. The empirical treatment for TBM remains the same as the treatment for pulmonary TB; the empirical treatment is warranted when clinical features and CSF findings are suggestive of TBM, even before microbiologic confirmation, since timely treatment dramatically improves the outcome of TBM [ 20 , 23 ].…”

“…It is worth mentioning that patients who present with TB with past medical history conditions are not treated similarly. For example, HIV patients are given the standard regimen of 2 months RIPE followed by 10 months of RI, but also given an ART therapy after [ 20 , 23 , 37 , 38 , 39 ]. Patients who develop syndrome of inappropriate antidiuretic hormone (SIADH) from M. tuberculosis infection should engage in fluid restriction and take medications such as furosemide and demeclocycline.…”

“…It concludes that although many drugs have certain efficacy against the disease, many have not been adequately studied and strong evidence cannot be found as to their ability to cross the blood brain barrier 38. A Case Report on Complicated Tuberculous Meningitis[38].JawadThis case follows a 19 years old Asan Female with Tb Meningitis in an attempt to study the importance of early diagnosis and treatment.VenketaramanGlutathione levels are significantly reduced in mononuclear cells and RBC isolated from TB patients. Treatment with n-acetyl cystine improves control by decreasing IL 1, IL 6, IL 10, and TNF alpha.…”

Tetraplegia associated with post-operative syringomyelia in spinal tuberculosis: a result of an epidural compartment syndrome?

“…However, multiple authors have reported high failure rate and poor long-term results of surgical treatment of arachnoiditisassociated syringomyelia [19][20][21]. Conservative treatment by steroids along with anti-tubercular therapy has been shown to produce neurological recovery in such patients [22,23]. Proponents of conservative treatment argue that the presence of arachnoiditis at different spinal levels makes the outcome of surgery hard to predict and unreliable.…”