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Febrile brain stroke and tuberculous meningitis: persisting threat in non-endemic countries

K Deiva1, S Sothratanak, B Husson

  • 1Pediatric Neurology Department, AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France. kumaran.deiva@bct.aphp.fr

Neuropediatrics
|March 30, 2011
PubMed

Insights

Tuberculous meningitis, though rare in non-endemic areas, can present as febrile stroke in infants. Prompt treatment of this serious infection leads to favorable outcomes, even with brain lesions.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Tuberculous meningitis (TBM) is rare in non-endemic regions.
  • Delayed diagnosis and treatment of TBM are associated with poor outcomes.

Observation:

  • A 13-month-old infant in a non-endemic country presented with symptoms suggestive of a febrile brain stroke.
  • Diagnostic workup revealed tuberculous arachnoiditis.

Findings:

  • Prompt initiation of specific anti-tuberculosis therapy led to a favorable clinical outcome.
  • An asymptomatic brain tuberculoma was observed but resolved spontaneously without intervention.

Implications:

  • Tuberculous meningitis should be considered in the differential diagnosis of febrile stroke in infants, even in non-endemic settings.
  • Early and specific treatment is crucial for improving patient outcomes in TBM.
  • The potential for spontaneous resolution of brain tuberculomas warrants further investigation.

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