Miliary Brain Tuberculomas and Meningitis: Tuberculosis Beyond the Lungs
  • Gisela Vasconcelos
    Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Ligia Santos
    Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Catarina Couto
    Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Margarida Cruz
    Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Alice Castro
    Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal

Keywords

Miliary tuberculosis, meningitis, brain tuberculomas

Abstract

Tuberculosis remains one of the most common infectious diseases. Miliary presentation is a rare and possibly lethal form, resulting from massive lymphohaematogenous dissemination of Mycobacterium tuberculosis bacilli. The authors describe the case of a 47-year-old immunocompetent woman, diagnosed with miliary tuberculosis, with both lung and central nervous system involvement, who showed total recovery after starting anti-tuberculous drugs. The atypical neutrophilic-predominant pleocytosis and negative cerebrospinal fluid microbiological results made the diagnosis even more challenging. Since prognosis largely depends on timely treatment, recognition and prompt diagnosis is important. Thus, clinicians should be aware and treatment should be initiated as soon as the diagnosis is suspected.

VIEW THE ENTIRE ARTICLE

References

  • Sharma SK, Mohan A, Sharma A, Mitra DK. Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis 2005;5(7):415–430.
  • Phypers M, Harris T, Power C. CNS tuberculosis: a longitudinal analysis of epidemiological and clinical features. Int J Tuberc Lung Dis 2006;10(1):99–103.
  • Garg RK, Sharma R, Kar AM, Kushwaha RAS, Singh MK, Shukla R, et al. Neurological complications of miliary tuberculosis. Clin Neurol Neurosurg 2010;112(3):188–192.
  • Rich AR. The pathogenesis of tuberculous meningitis. Bull John Hopkins Hosp 1933;52:5.
  • Davis AG, Rohlwink UK, Proust A, Figaji AA, Wilkinson RJ. The pathogenesis of tuberculous meningitis. J Leukoc Biol 2019;105(2):267–280.
  • Marx GE, Chan ED. Tuberculous meningitis: diagnosis and treatment overview. Tuberc Res Treat 2011;2011:798764.
  • Farer LS, Lowell AM, Meador MP. Extrapulmonary tuberculosis in the United States. Am J Epidemiol1979;109(2):205–217.
  • Kent SJ, Crowe SM, Yung A, Lucas CR, Mijch AM. Tuberculous meningitis: a 30-year review. Clin Infect Dis 1993;17(6):987–994.
  • Agarwal AK, Bansal S, Nand V. A hospital based study on estimation of adenosine deaminase activity (ADA) in cerebrospinal fluid (CSF) in various types of meningitis. J Clin Diagn Res 2014;8(2):73–76.
  • Views: 806
    HTML downloads: 264
    PDF downloads: 466


    Published: 2020-09-14
    Issue: 2020: Vol 7 No 12 (view)


    How to cite:
    1.
    Vasconcelos G, Santos L, Couto C, Cruz M, Castro A. Miliary Brain Tuberculomas and Meningitis: Tuberculosis Beyond the Lungs. EJCRIM 2020;7 doi:10.12890/2020_001931.

    Similar Articles

    You may also start an advanced similarity search for this article.

    Most read articles by the same author(s)