Paradoxical Infarct in Tuberculous Meningitis: A Case Report

被引:3
作者
Morioka, Hiroshi [1 ]
Matsumoto, Shuuichi [2 ]
Kojima, Eiji [2 ]
Takada, Kazuto [2 ]
Iwata, Susumu [2 ]
Okachi, Shoutaro [3 ]
机构
[1] Tokyo Metropolitan Komagome Hosp, Div Infect Dis, Tokyo, Japan
[2] Komaki Municipal Hosp, Div Resp & Allergy Med, Komaki, Japan
[3] Nagoya Univ, Grad Sch Med, Dept Resp Med, Nagoya, Aichi 4648601, Japan
关键词
tuberculous meningitis; paradoxical reaction; miliary tuberculosis; infarct; central nervous system tuberculosis; STROKE;
D O I
10.2169/internalmedicine.51.6830
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We describe a case of 78-year-old woman with a 1-week history of fever and left hemiparesis. Head magnetic resonance imaging showed a small infarct. After admission, she showed altered consciousness and another small infarct. She finally had diagnoses of miliary tuberculosis (miliary-TB) and tuberculous meningitis (TBM). She recovered after receiving anti-tuberculous therapy (ATT) with prednisolone. However, 5 weeks later, we found another infarct. This is a rare case of TBM with recurrent infarcts in atypical lesions in spite of ATT. We suggest the possibility that the new infarct after ATT was due to a paradoxical reaction.
引用
收藏
页码:949 / 951
页数:3
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