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Efficacy of Intrathecal Isoniazid and Steroid Therapy in Refractory Tuberculous Meningitis

Nobuyuki Ashizawa1,2, Ryotaro Kubo2, Ryuta Tagawa2,3

  • 1Infection Control and Education Center, Nagasaki University Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|June 21, 2023
PubMed

Tuberculous meningitis is an infectious disease with high mortality. Literature describing intrathecal therapy for tuberculous meningitis is scarce. We herein report a case of refractory tuberculous meningitis in a 52-year-old woman with underlying neuropsychiatric systemic lupus erythematosus. Despite systemic treatment with anti-tuberculosis drugs and dexamethasone, her meningeal irritation deteriorated. Intrathecal isoniazid and prednisolone administration was therefore initiated, and the symptoms of severe meningeal irritation improved along with head magnetic resonance imaging and cerebrospinal fluid findings. This case report highlights the efficacy of intrathecal isoniazid and steroid injections for refractory tuberculous meningitis, particularly in patients with severe meningeal irritation.

Keywords:
intrathecal injectionneuropsychiatric systemic lupus erythematosus (NPSLE)tuberculous meningitis

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