title: Cerebral tuberculosis presenting as complex febrile convulsions.
abstract: Complex febrile convulsions were the initial clinical manifestation of miliary tuberculosis in a 4-year-old immigrant girl. The cerebral lesions were visible only after contrast-enhanced cranial computed tomography (CT) while native CT scan as well as cell count and glucose concentration in the cerebrospinal fluid were normal. Mycobacterium tuberculosis was cultured from gastric aspirate and liver biopsy tissue. Treatment with isoniazid and rifampin for 12 months, pyrazinamide for 9 months, and ethambutol for the initial 6 weeks resulted in resolution of the cerebral lesions but a retinal scar after granuloma formation in the right eye caused reduced visus. This case demonstrates the importance of thorough search for tuberculosis even in the absence of overt clinical pulmonary signs especially in high-risk individuals such as immigrants.
authors.affiliation: Infectious Diseases Unit, University Children's Hospital of Zürich, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Berger
authors.forename: C P
authors.initials: CP
authors.lastname: Braegger
authors.forename: M
authors.initials: M
authors.lastname: Albisetti
authors.forename: K
authors.initials: K
authors.lastname: Landau
authors.forename: D
authors.initials: D
authors.lastname: Nadal
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D003294:Seizures, Febrile / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents