[Diagnostic difficulties in tuberculosis meningoencephalitis].
Tuberculous meningoencephalitis (TBM) is a rarely diagnosed form of tuberculosis. It is characterised with high mortality. Only rapidly started treatment allows to patient's survival. However, bacteriologic prove of the diagnosis is achieved only in 40% of cases. It was hoped that introduction of PCR to clinical practice, would allow rapid and unquestionable diagnosis. We present case of male with lymphocytic bacterial meningoencephalitis in whom tuberculous etiology was suspected. The diagnosis was abandoned when negative results of PCR was obtained. As cessation of treatment led to dramatic worsening of patients state, the antituberculosis therapy was restarted. After 2 months of therapy, complete clinical remission was achieved. Nevertheless, computed tomography of brain revealed clinically asymptomatic hydrocephalus. Presented case shows that the treatment is effective, it should not be ended even in case of negative results of PCR test.
Piekarska
Anna
A
Klinika Chorób Zakaźnych AM w Łodzi.
Kuydowicz
Jan
J
D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification / Q000472:pathogenicity*; D013997:Time Factors; D020306:Tuberculosis, Central Nervous System / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
D000995:Antitubercular Agents
Trudności diagnostyczne w przypadku gruźliczego zapalenia opon mózgowo-rdzeniowych i mózgu.