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Pediatric acute hydrocephalus developing after tubercular meningitis: a case report study
Maryam Kachuei1, Ramin Zare1, Zahra Sadr1
1Firoozabadi Clinical Research Development Unit (FACRDU).
Insights
Tuberculous meningitis (TBM) can cause rare central nervous system complications. This case highlights acute hydrocephalus as an atypical consequence of disseminated tuberculosis in an adolescent.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) is a leading infectious cause of mortality worldwide.
- Tuberculous meningitis (TBM) presents with severe central nervous system complications, particularly in pediatric populations.
- TBM can manifest with unusual neurological sequelae.
Observation:
- A 15-year-old female presented with altered mental status, cough, nausea, and weakness.
- Imaging revealed cavitary lung lesions, low cerebrospinal fluid glucose, and acute hydrocephalus.
- The patient received anti-tubercular therapy and neurosurgical intervention.
Findings:
- Disseminated tuberculosis led to tuberculous meningitis.
- Acute hydrocephalus was identified as a rare complication of TBM.
- Cerebrospinal fluid analysis indicated infection and inflammation.
Implications:
- This case underscores the importance of considering TBM in patients with neurological symptoms and disseminated TB.
- Recognizing rare complications like hydrocephalus is crucial for timely management.
- Prompt diagnosis and treatment of TBM can prevent severe neurological damage.
Background:
Tuberculosis ranks second as the most common cause of death among infectious diseases, preceded only by COVID-19, which can involve multiple organs. Tuberculous meningitis (TBM) is known to have serious and atypical complications affecting the central nervous system, especially in more vulnerable populations such as children and adolescents.
Case Presentation:
The 15-year-old female patient was admitted to the hospital with altered mental status after complaining of nausea, weakness, and cough for 3 weeks. A chest computed tomography (CT) scan showed cavitary lesions, a lumbar puncture sample had a glucose level of 15 mg/dl, and the brain CT scan revealed acute hydrocephalus. While the patient was treated with anti-tubercular medications, an external ventricular drain was placed and the patient was monitored.
Conclusion:
This report presents acute hydrocephalus as a rare and atypical consequence of disseminated tubercular infection resulting in meningitis.
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