title: Paradoxical infarct in tuberculous meningitis: a case report.
abstract: We describe a case of 78-year-old woman with a 1-week history of fever and left hemiparesis. Head magnetic resonance imaging showed a small infarct. After admission, she showed altered consciousness and another small infarct. She finally had diagnoses of miliary tuberculosis (miliary-TB) and tuberculous meningitis (TBM). She recovered after receiving anti-tuberculous therapy (ATT) with prednisolone. However, 5 weeks later, we found another infarct. This is a rare case of TBM with recurrent infarcts in atypical lesions in spite of ATT. We suggest the possibility that the new infarct after ATT was due to a paradoxical reaction.
authors.affiliation: Division of Infectious Disease, Tokyo Metropolitan Komagome Hospital, Japan. h-morioka@cick.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morioka
authors.forename: Shuuichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Kojima
authors.forename: Kazuto
authors.initials: K
authors.lastname: Takada
authors.forename: Susumu
authors.initials: S
authors.lastname: Iwata
authors.forename: Shoutaro
authors.initials: S
authors.lastname: Okachi
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000008:administration & dosage; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D011239:Prednisolone