Miliary tuberculosis with meningovascular involvement

The case of a 20-year-old male patient is presented, with an illness of one week characterized by asthenia, hyporexia, nausea, vomiting, neck stiffness, intermittent headache of intensity 9/10, fever quantified at 38.5. °C, scant dry cough, weight loss and left hemiparesis without loss of consciousn...

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Detalles Bibliográficos
Autores: Mesía-Ángeles, Diego, Simon-Lagos, Pilar, Cuti-Simon, Félix E., Navarro- Yparraguirre, Madelaine, Medina-Soriano, Carlos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Perú
Institución:Sociedad Peruana de Medicina Interna
Repositorio:Revista de la Sociedad Peruana de Medicina Interna
Idioma:español
OAI Identifier:oai:medicinainterna.net.pe:article/781
Acceso en línea:https://revistamedicinainterna.net/index.php/spmi/article/view/781
Access Level:acceso abierto
Palabra clave:Tuberculosis miliar
Tuberculosis delsistema nervioso central
uberculosis resistente a múltiples drogas
milliary tuberculosis
Central nervous system tuberculosis
Multidrug-resistant tuberculosis
Descripción
Sumario:The case of a 20-year-old male patient is presented, with an illness of one week characterized by asthenia, hyporexia, nausea, vomiting, neck stiffness, intermittent headache of intensity 9/10, fever quantified at 38.5. °C, scant dry cough, weight loss and left hemiparesis without loss of consciousness. Serological tests, including HIV, were negative. The spinal fluid showed pleocytosis with a predominance of mononuclear cells, hyperproteinorrachia and hypoglycorrhachia, with a positive GeneXpert MTB/RIF test for M. tuberculosis resistant to rifampicin, in addition to a positive sputum smear for the same germ. The images showed a miliary pattern and vascular compromise (bilateral hypodensities at the level of the basal ganglia and internal capsule). He was treated as multidrug-resistant systemic tuberculosis with a favorable outcome.