title: Infantile Tubercular Meningitis With Brain Infarct.
abstract: A previously healthy 6-month-old Asian girl presented to the emergency department (ED) after 7 to 10 days of fever of 101 to 102°F, cough, and intermittent vomiting. Pneumonia was diagnosed and successfully treated, and the patient was discharged. She returned to the ED after her mother noticed mild facial asymmetry, left upper extremity weakness, and an episode of jerkiness. The mother then revealed that both she and the child's maternal grandmother, who also lived with the patient, had suffered chronic coughs in recent months. The mother's previous chest radiograph showed pulmonary tuberculosis. The patient's magnetic resonance imaging findings were consistent with a cerebrovascular event. Positive results on cerebrospinal fluid analysis, the mother's suspicious tuberculosis-like history, and the patient's clinical symptoms pointed heavily toward a diagnosis of tuberculous meningitis. A 4-drug antituberculosis regimen with dexamethasone was instituted and scheduled to continue for 12 months. However, the patient returned to the ED 2 months later after developing an obstructive hydrocephalus.
authors.affiliation: From the *Department of Pediatrics, Drexel University College of Medicine, and St. Christopher's Hospital for Children, Philadelphia, PA; and †Department of Pediatrics, Drexel University College of Medicine, The Unterberg Children's Hospital at Monmouth Medical Center, Long Branch, NJ.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kratimenos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Koutroulis
authors.forename: Mike
authors.initials: M
authors.lastname: Fruscione
authors.forename: Hazeez
authors.initials: H
authors.lastname: Adigun
authors.forename: Richard
authors.initials: R
authors.lastname: DeGroote
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Fisher
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D020520:Brain Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007223:Infant; D008279:Magnetic Resonance Imaging; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents