rss
BMJ Case Reports 2012; doi:10.1136/bcr.10.2011.5005
  • Unusual presentation of more common disease/injury

Tuberculous radiculomyelitis presenting as urinary retention in a child with Down’s syndrome

  1. Lara Abulhoul
  1. Children’s Hospital, Leicester Royal Infirmary, Leicester, UK
  1. Correspondence to Dr Arani Sridhar, arani.sridhar{at}uhl-tr.nhs.uk

Summary

Tuberculous radiculomyelitis (TBRM) is an uncommon complication of TB meningitis. The authors report the case of a 10-year-old Asian girl with trisomy 21, who presented with acute urinary retention and fever. She was initially treated for a urinary tract infection. After an acute neurological deterioration she was found to have evidence of TB meningitis with TBRM. She developed acute hydrocephalus requiring ventriculo-peritoneal shunt. She was treated with quadruple antituberculous therapy and high dose intravenous dexamethasone. She needed tracheostomy with continuous positive airway pressure (CPAP) support. Although she showed gradual neurological improvement in her cognitive functions, she persisted to have quadriparesis with the need for tracheostomy and CPAP support overnight and gastrostomy feeding. Acute urinary retention in children is uncommon, and should serve as a ‘red flag’ to consideration of further underlying neurological problems. This presentation and subsequent events should serve as a learning point to clinicians.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

This article has not yet been cited by other articles.

No Related Web Pages

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article