Tuberculous Meningitis: The Important Role of Imaging

Date of submission: 06-12-2020 | Date of acceptance: 12-04-2021 | Published: 03-10-2021

Authors

  • Ana Pereira Lemos Pediatric Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar e Universitário Lisboa Central, Lisboa, Portugal
  • Andreia Duarte Constante Pediatric Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar e Universitário Lisboa Central, Lisboa, Portugal
  • Carla Conceição Department of Pediatric Neuroradiology, Hospital Dona Estefânia, Centro Hospitalar e Universitário Lisboa Central, Lisboa, Portugal
  • José Pedro Vieira Department of Pediatric Neurology, Hospital Dona Estefânia, Centro Hospitalar e Universitário Lisboa Central, Lisboa, Portugal
  • Maria João Brito Pediatric Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar e Universitário Lisboa Central, Lisboa, Portugal

DOI:

https://doi.org/10.25754/pjp.2021.21668

Abstract

Tuberculous meningitis is the most severe form of tuberculosis and the diagnosis continues to be challenging for clinicians. Indeed, many cases of Tuberculous meningitis cannot be confirmed based on clinical findings and laboratory techniques are largely insensitive or slow. Clinical presentation can be nonspecific and suggest alternative conditions. The difficulty in diagnosis often leads to a delay in treatment and subsequent mortality.

We present a case of a four-year-old indian girl with meningitis that presented a clinical deterioration with neurological signs while under antibiotics. The epidemiological history and the neuroimaging findings of incipient hydrocephalus, infarcts and probable tuberculomas, were essential to evoke the diagnosis of Tuberculous meningitis. Diagnosis of Tuberculous meningitis is difficult as it can clinically present similarly to other forms of meningitis. The recognition of this entity involves a high index of suspicion based on the previous referred findings and is essential in terms of morbidity and mortality.

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Published

2021-11-03

Issue

Section

Case reports

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