Breakthrough neurological manifestation during appropriate antituberculous therapy of miliary tuberculosis.
We report a 20-month-old girl with miliary pulmonary tuberculosis and normal neurological findings. While on treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol for 1 month, she developed weakness of the lower extremities without meningism or altered consciousness. A computerized tomogram revealed tuberculomas and basal arachnoiditis. The cerebrospinal fluid findings were compatible with tuberculous meningitis. She responded well to systemic corticosteroids.
Lolekha
Rangsima
R
Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. rangsima_l@yahoo.com
Chokephaibulkit
Kulkanya
K
Vanprapar
Nirun
N
Phongsamart
Wanatpreeya
W
Chearskul
Sanay
S
D000995:Antitubercular Agents / Q000009:adverse effects*; D001100:Arachnoiditis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D004342:Drug Hypersensitivity / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D011239:Prednisolone / Q000627:therapeutic use; D014375:Tuberculoma / Q000139:chemically induced* / Q000276:immunology; D014390:Tuberculosis, Meningeal / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D014391:Tuberculosis, Miliary / Q000188:drug therapy*
D000995:Antitubercular Agents; D005938:Glucocorticoids; D011239:Prednisolone