Concomitant tuberculous meningitis and Lutembacher syndrome with multiple atrial septal defects and infective endocarditis.
Lutembacher syndrome is a rare combination of atrial septal defect (ASD) and mitral stenosis. Symptoms depend on the size of ASD, extent of mitral stenosis and degree of changes in the pulmonary circulation. Presentation can be due to cardiac failure, atrial arrhythmias, dyspnoea, exercise intolerance, paradoxical emboli or other disease related complications like pulmonary hypertension and infective endocarditis. Tuberculous meningitis is a chronic infection due to haematogenous dissemination of tubercle bacilli from lungs. It can lead to complications like cranial nerve palsies, hydrocephalus, cerebral oedema or focal neurological deficits presenting as stroke. The treatment should include antituberculous therapy for one year and corticosteroids for initial 4-6 weeks depending on the symptoms of the patient. This report describes the concomitant occurrence of all these conditions at a time in a 45 years old lady.
Department of Medicine, Mayo Hospital, Lahore, Pakistan. dr_samarfirdous@yahoo.com
Samar
S
Firdous
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000995:Antitubercular Agents / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004696:Endocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D006976:Hypertension, Pulmonary; D008185:Lutembacher Syndrome / Q000150:complications*; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011859:Radiography; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014640:Vancomycin / Q000008:administration & dosage; D034363:Viridans Streptococci / Q000302:isolation & purification
D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents; D014640:Vancomycin; D003907:Dexamethasone