Tuberculous meningitis, an unusual presentation in a young lady

BMJ Case Rep. 2012 Jul 9:2012:bcr1220115370. doi: 10.1136/bcr.12.2011.5370.

Abstract

A 37-year-old Persian-speaking woman presented with epigastric pain, vomiting and non-specific frontal headache. Examination was unremarkable except for an isolated sixth nerve palsy found a few days after admission. Blood results were normal, as was the chest radiograph and the CT scan of the head. Initial cerebrospinal fluid (CSF) analysis revealed a significantly elevated protein level with reduced glucose, as well as CSF lymphocytosis. Tuberculosis (TB) meningitis was considered and she was commenced on anti-TB treatment before confirmation of the diagnosis. A full contact tracing was performed with regular follow-up with TB nurses. When she was seen in the clinic a month later, her symptoms had subsided completely.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebrospinal Fluid / microbiology
  • DNA, Bacterial / analysis
  • Diagnosis, Differential
  • Female
  • Headache / diagnosis
  • Headache / etiology*
  • Humans
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification
  • Polymerase Chain Reaction
  • Tomography, X-Ray Computed
  • Tuberculosis, Meningeal / complications
  • Tuberculosis, Meningeal / diagnosis*
  • Tuberculosis, Meningeal / microbiology
  • Vomiting / diagnosis
  • Vomiting / etiology*

Substances

  • DNA, Bacterial