Acute tuberculous meningitis with fulminant fatal evolution in a 69-year-old man
- Gabriel Brisou1,
- Thomas Perpoint1,
- Gaël Bourdin1,
- Tristan Ferry1,2,3
- 1Hospices Civils de Lyon, Lyon, France
- 2Université Claude Bernard, Lyon 1, France
- 3Pathogénie Bactérienne et Immunité Innée, INSERM U851, Lyon, France
- Correspondence to Dr Tristan Ferry, tristan.ferry{at}univ-lyon1.fr
Description
An immunocompetent (HIV-negative) 69-year-old Caucasian man with a history of paramedian pontine acute ischaemic stroke requiring intravenous thrombolysis 1 year earlier (ataxia as sequelae only) was admitted with a 7-day history of fever. The patient was in a confused state at admission, with known ataxia but without other neurological signs. His mental status worsened 4 days after admission with occurrence of a coma and neck stiffness. Mild hydrocephalus was observed on a first MRI (figure 1A), and ventriculoperitoneal shunt was not performed. Central nervous system tuberculosis was finally diagnosed (cerebrospinal fluid (CSF) …
