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Tuberculosis Meningitis in a 9-Month-Old Girl during the COVID-19 Pandemic

Amir-Hassan Bordbari1, Kobra Sheidaee2, Azin Hajialibeig2

  • 1Student Research Committee School of Medicine Mazandaran University of Medical Sciences, Sari, Iran.

Case Reports in Medicine
|September 30, 2024
PubMed

Insights

Tuberculous meningitis (TBM) can mimic stroke symptoms in infants, delaying critical diagnosis. Early TBM recognition is vital, especially with overlapping symptoms during the COVID-19 pandemic.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Tuberculous meningitis (TBM) is a severe form of tuberculosis with significant neurological sequelae.
  • Delayed diagnosis and treatment of TBM contribute to high morbidity and mortality rates.

Observation:

  • A 9-month-old infant presented with vomiting, focal seizures, and hemiparesis.
  • Brain imaging revealed leptomeningeal enhancement, hydrocephalus, basal ganglia lesion, vasculitis, and ischemic changes.
  • Initial misdiagnosis as stroke delayed appropriate TBM treatment.

Findings:

  • Diagnostic workup confirmed TBM as the underlying cause of the neurological symptoms.
  • The clinical presentation and imaging findings mimicked acute ischemic stroke.

Implications:

  • This case underscores the importance of considering TBM in pediatric neurological emergencies.
  • Awareness of TBM is crucial during the COVID-19 pandemic due to overlapping symptoms with SARS-CoV-2 and MIS-C complications.

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