A fatal case of tuberculous meningitis in a child with juvenile idiopathic arthritis: a diagnostic challenge

被引:5
作者
Bal, Zumrut Sahbudak [1 ]
Yazici, Pinar [1 ]
Sen, Semra [1 ]
Eraslan, Cenk [2 ]
Cavusoglu, Cengiz [3 ]
Karapinar, Bulent [1 ]
Vardar, Fadil [1 ]
机构
[1] Ege Univ, Dept Pediat, Med Sch, Izmir, Turkey
[2] Ege Univ, Dept Radiol, Med Sch, Izmir, Turkey
[3] Ege Univ, Dept Microbiol & Clin Microbiol, Med Sch, Izmir, Turkey
关键词
Tuberculosis; Tumor necrosis factor antagonist; Juvenile idiopathic arthritis; RHEUMATOID-ARTHRITIS; RISK; THERAPY;
D O I
10.1590/0037-8682-0410-2016
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
The prognosis of tuberculous meningitis, a rare form of extrapulmonary tuberculosis, depends on the stage of treatment initiation. We report a fatal case of tuberculous meningitis. The patient had received successive tumor necrosis factor (TNF) antagonists and abatacept to treat juvenile idiopathic arthritis, with negative results for polymerase chain reaction and acid-fast bacilli on smear, had normal cerebrospinal fluid (CSF) adenosine deaminase and glucose levels. Six weeks post-admission, the CSF culture demonstrated Mycobacterium tuberculosis. The altered immunological responses caused by anti-TNF treatment made the diagnosis challenging. Clinicians should bear this in mind and, if suspected, treatment should be initiated immediately.
引用
收藏
页码:709 / 711
页数:3
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