Abstract
Tuberculosis is the most common cause of infectious disease related mortality worldwide. Paradoxical reactions to antituberculous treatment have created difficulties in the management of extrapulmonary tuberculosis, particularly central nervous system tuberculosis. We report a three years baby with tuberculous meningitis, who was treated outside with anti-tuberculous drugs without steroid one month back and presented in our emergency as status epilepticus. This case emphasizes the importance of addition of steroid along with anti-tubercular drugs in the treatment of central nervous system tuberculosis. J Nepal Paediatr Soc 2014;34(3):236-238 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10752
Highlights
India had an es mated 2.3 million (26% of global burden) Tuberculosis (TB) cases in 2010, and ranked 16th in terms of incidence rate amongst 22 highest TB burden countries1]
We report a 3 years old baby with tuberculous meningi s, who was treated outside with an -tuberculous drugs without steroid one month back and presented in our emergency as status epilep cus
Four weeks ago the pa ent was diagnosed as tuberculous meningi s in a private hospital on the basis of prolonged fever, vomi ng, convulsion, posi ve tuberculin test, history of tuberculous contact, posi ve meningeal signs and cerebrospinal fluid analysis
Summary
India had an es mated 2.3 million (26% of global burden) Tuberculosis (TB) cases in 2010, and ranked 16th in terms of incidence rate amongst 22 highest TB burden countries1]. Four weeks ago the pa ent was diagnosed as tuberculous meningi s in a private hospital on the basis of prolonged fever, vomi ng, convulsion, posi ve tuberculin test, history of tuberculous contact, posi ve meningeal signs and cerebrospinal fluid analysis. Her ini al computed tomography (CT) Scan brain did not showed any ring enhancing lesion (Figure 1). She was started on 4 drugs ATT without steroid consis ng of isoniazid, rifampicin, pyrazinamide and ethambutol as intensive phase for two months, all taken once daily in morning empty stomach per orally.
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