A fatal case of tuberculous meningitis in a child with juvenile idiopathic arthritis: a diagnostic challenge
Rev. Soc. Bras. Med. Trop
;
50(5): 709-711, Sept.-Oct. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-897014
ABSTRACT
Abstract The prognosis of tuberculous meningitis, a rare form of extrapulmonary tuberculosis, depends on the stage of treatment initiation. We report a fatal case of tuberculous meningitis. The patient had received successive tumor necrosis factor (TNF) antagonists and abatacept to treat juvenile idiopathic arthritis, with negative results for polymerase chain reaction and acid-fast bacilli on smear, had normal cerebrospinal fluid (CSF) adenosine deaminase and glucose levels. Six weeks post-admission, the CSF culture demonstrated Mycobacterium tuberculosis. The altered immunological responses caused by anti-TNF treatment made the diagnosis challenging. Clinicians should bear this in mind and, if suspected, treatment should be initiated immediately.
Full text:
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Index:
LILACS (Americas)
Main subject:
Arthritis, Juvenile
/
Tuberculosis, Meningeal
/
Tumor Necrosis Factor Inhibitors
/
Antitubercular Agents
Type of study:
Diagnostic study
/
Prognostic study
Limits:
Adolescent
/
Humans
/
Male
Language:
English
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
Tropical Medicine
Year:
2017
Type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
Medical School of Ege University/TR
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