Cerebral meningitis due to tuberculoma and epstein barr: presentation of a clinical case

Abstract

Neuroinfection is an inflammatory process that affects the meninges or brain parenchyma; it has various etiologies, including viral and non-viral, including autoimmune, bacterial and fungal; patients with this pathology represent a challenge for doctors; the severity varies, from benign, self-limiting to life-threatening. The Epstein-Barr virus (EBV) is a double-stranded DNA gamma herpesvirus that presents a latent infection and lytic replication; it can diffuse into the central nervous system and alter the integrity of the blood-brain barrier, being associated with neurocognitive impairment, neuronal damage and inflammation. In relation to tuberculosis, it became the second infectious disease that caused the most deaths in the world after COVID-19; tuberculous meningitis is considered the most severe form of extrapulmonary tuberculosis (TB) with a mortality of 70% in low-income countries. Below is the case of a 35-year-old man with a history of adrenal insufficiency and hyperthyroidism, who was receiving corticosteroids; he went to the emergency service with a 5-month history of clinical symptoms characterized by holocranial headache, focal retrograde amnesia, periods of altered state of consciousness, dizziness, nausea that led to vomiting on several occasions, with sudden loss of consciousness. , accompanied by involuntary tonic-clonic movements and hearing loss; after the diagnostic screening, EBV and TB are identified; receives specific treatment with good clinical evolution