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Related Experiment Video

Updated: Dec 18, 2025

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Lessons learnt from an old foe.

Sushma Krishna1, Ranjini Srinivasan1

  • 1Department of Paediatrics, St. Johns Medical Hospital, Bangalore, India.

The Indian Journal of Tuberculosis
|June 20, 2020
PubMed
Summary

Standard treatment for tuberculous meningitis (TBM) is effective, but some patients experience prolonged illness. This case highlights that even immunocompetent individuals may have protracted courses with complications despite therapy.

Keywords:
CSF-cerbrospinal fluidCerebral salt wasting (CSW)Cerebrospinal fluid pleocytosisTubercular meningitis (TBM)

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Neurotuberculosis, specifically tuberculous meningitis (TBM), is a serious infection of the central nervous system.
  • Standard antitubercular therapy is the cornerstone of TBM management and is often highly effective.

Observation:

  • An 11-year-old immunocompetent boy presented with TBM.
  • The patient exhibited an unusual clinical course characterized by prolonged fever, persistent hyponatremia, and cerebrospinal fluid (CSF) pleocytosis.
  • These symptoms persisted despite receiving adequate antitubercular treatment.

Findings:

  • The case demonstrates that TBM management can be protracted.
  • Complications can arise even with appropriate and timely therapy.
  • Individual patient responses to TBM treatment can vary significantly.

Implications:

  • Clinicians should be aware of potential prolonged courses and complications in TBM management, even in immunocompetent patients.
  • This case underscores the need for vigilant monitoring and individualized treatment approaches in TBM.
  • Further research may be warranted to understand factors contributing to protracted TBM courses.