Meningitis tuberkulosoa, ezohikoa baina posiblea

Abstract

Tuberculosis is an underdiagnosed infection. Young children are at greater risk of suffering from severe extrapulmonary forms. In 4% of children with Mycobacterium tuberculosis infection, the disease extends to the central nervous system. Among the conditions that induce the greatest morbidity and mortality is tuberculous meningitis.

As a result of this, we will analyze three cases of tuberculous meningitis with follow-up in Basurto Hospital to raise awareness about this entity. The first one was a 14-year-old girl who was admitted for disturbance, confusion and dysphasia and Mycobacterium tuberculosis DNA was detected in the cerebrospinal fluid with good clinical evolution after treatment. The other two cases consulted for long-term fever, a 12-month-old boy with cough and rhinorrhea and an 18-month-old girl with vomiting. Both developed hydrocephalus and required placement of a ventriculoperitoneal valve. In all cases microbiological tests were positive. All three presented hypoglycorrhachia, elevated protein levels and pleocytosis. In all of them the index case was a relative.

In the case of tuberculous meningitis, early diagnosis is key for prognosis. However, there are difficulties in performing it, especially because at first the symptoms are nonspecific and the microbiological tests have low profitability. For this reason, it is important to include it in the differential diagnosis and ask about family members who could have tuberculosi.