Tuberculous meningitis, an unusual presentation in a young lady.
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.
Department of Acute Medicine, Walsall Healthcare NHS Trust, Walsall, UK.
Tanveer
T
Chohan
Arihant
A
Jain
Marwa
M
Saeed
Saad Aldeen
SA
Saeed
Upul Kumara
UK
Dharmasena
D000328:Adult; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D014057:Tomography, X-Ray Computed; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology*
D004269:DNA, Bacterial