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[Tuberculoma complicating tuberculous meningitis: description of one paediatric case]
C Ruggeri1, M Valenzise, M M Alosi
1U.O. di Clinica Pediatrica, Dipartimento di Scienze Pediatriche Mediche e Chirurgiche, Università degli Studi di Messina, Messina. cruggeri@unime.it
Abstract:
Intracranial tuberculoma is a possible complication of meningeal, miliary or pulmonary tuberculosis. In developing countries it represents 30% of space-occupying intracranial lesions, in industrialised countries only 0.1-0.2%. One recently recognised phenomenon is the development ex novo or the enlargement of the tuberculoma during antitubercular chemo-antibiotic therapy. Here we report the clinical case of an immunocompetent Italian baby girl who presented an intracranial tuberculoma during tuberculous meningitis. We underline how such an event is possible, the need for early neuroradiological evaluation and its favourable course, maintaining adequate antitubercular therapy associated with steroid therapy.
Insights
Intracranial tuberculoma can develop during tuberculous meningitis, even in immunocompetent children. Early neuroradiological evaluation and combined antitubercular and steroid therapy are crucial for favorable outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Intracranial tuberculoma is a serious complication of tuberculosis, more prevalent in developing nations.
- It can manifest as a space-occupying lesion within the brain.
- A rare phenomenon involves tuberculoma development or enlargement during antitubercular treatment.
Observation:
- A case report details an immunocompetent Italian infant diagnosed with tuberculous meningitis.
- The infant presented with an intracranial tuberculoma.
- This occurred despite ongoing antitubercular chemotherapy.
Findings:
- Intracranial tuberculoma can arise de novo or enlarge during antitubercular therapy.
- Early neuroradiological imaging is essential for timely diagnosis.
- Combined antitubercular and steroid therapy led to a favorable clinical course.
Implications:
- Highlights the possibility of intracranial tuberculoma development during treatment for tuberculosis.
- Emphasizes the importance of vigilant neuroradiological monitoring in pediatric tuberculous meningitis.
- Suggests that prompt and appropriate medical intervention can lead to positive patient outcomes.
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