Tuberculous meningitis, an unusual presentation in a young lady

Isolated De Novo Headache as the Presenting Symptom of Listeria Meningitis: A Report of 2 Cases

“…Only between 0.5% and 4% of all attended headaches end up in the diagnosis of infectious meningitis, 14‐16 but the potential severity of this diagnosis makes it one of the main causes to exclude. Atypical presentations may involve a diagnostic challenge and, as we have seen, isolated headache can be the only presenting symptom in some infectious meningitis such as Listeria, but also in others such as tuberculosis, that occur mainly in some developing countries 17 . The cases reported here, besides presenting some traditional headache red flags, did not fulfill the ICHD‐3 diagnostic criteria 6 for any primary headache.…”

“…Atypical presentations may involve a diagnostic challenge and, as we have seen, isolated headache can be the only presenting symptom in some infectious meningitis such as Listeria, but also in others such as tuberculosis, that occur mainly in some developing countries. 17 The cases reported here, besides presenting some traditional headache red flags, did not fulfill the ICHD-3 diagnostic criteria 6 for any primary headache. These criteria are largely based on the number and duration of the episodes, accompanying symptoms and exclusion of an alternative diagnosis, and their application in the ED has shown a high predictive value for secondary headaches in a recent publication.…”

Isolated Cranial Nerve VI Palsy and Neurosyphilis: A Case Report and Review of Related Literature

“…In summary, there are a multitude of differential diagnoses for an isolated cranial neuritis but infectious causes should be considered depending on the patient profile and his clinical presentation. Some other infectious agents reported to cause isolated craniopathies are Mycobacterium tuberculosis [16] , Varicella-Zoster virus [17] , Dengue virus [18] , Epstein-Barr virus [19] , and Cryptococcus neoformans [20] to name a few. Despite the advances in the work-up and management of neurosyphilis, there is still a need to further streamline these developments to unify the diagnostic criteria and cornerstones of management.…”

Severe hyponatremia and MRI point to diagnosis of tuberculous meningitis in the Southwest USA

“…According to British Infection Society guidelines, diagnosis of TM is best obtained with lumbar puncture and examination of CSF 10 11. Characteristic CSF findings in TM include a predominantly lymphocytic leucocytosis, a rise in CSF protein, and CSF to plasma glucose of ratio less than 50% 10 Table 2.…”

“…Characteristic CSF findings in TM include a predominantly lymphocytic leucocytosis, a rise in CSF protein, and CSF to plasma glucose of ratio less than 50% 10 Table 2. outlines the differences seen in CSF analysis among bacterial, viral and tuberculosis meningitis.…”