Tuberculous meningo-encephalitis complicated by hydrocephalus in HIV patient

ABSTRACT

Hydrocephalus is a serious complication of tuberculous meningoencephalitis in HIV patients. The disease can affect vital and functional prognosis of patients. A 20 years-old woman was admitted for deterioration of her consciousness. She has a history of HIV infection since 3 months. Cerebral imagery showed signs of tuberculous meningoencephalitis. The paient was treated by antituberculous therapy with a good evolution. At the third months of treatment the patient presented roughly alteration of her consciousness and intracranial hypertension. Cerebral scan showed active ventricle hydrocephalous. The patient had ventricle extern derivation and then ventricle peritoneal derivation. Antituberculous and antiretroviral therapies were maintained. The outcome was favourable [follow up of one year]. central nervous system involvement in HIV patient can be observed at any stage of the disease with a consequent mortality and morbidity. central nervous system tuberculosis is observed in 10% of patients who presented an association of HIV-tuberculosis and only in 2% to 5% of tuberculous immunocompetent patients. Hydrocephalous is observed in 32% to 51% of HIV patients associated with tuberculosis meningoencephalitis. Hydrocephalous is a common complication of tuberculous meningoencephalitis witch can worsened the neurological statue of HIV infected patient. An early surgical and medical management was associated with a good prognosis