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
相关论文
共 50 条
[41]   Tuberculous Meningitis: A Report of 60 Adult Cases [J].
Ersoz, M. ;
Yildirmak, M. T. ;
Gedik, H. ;
Simsek, F. ;
Kanturk, A. ;
Iris, N. E. ;
Dinc, E. .
WEST INDIAN MEDICAL JOURNAL, 2012, 61 (06) :592-597
[42]   Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis [J].
Qin, Ningxiang ;
Wu, Xingguo ;
Wang, Jing ;
Wang, Wei ;
Wang, Xuefeng ;
Ma, Yuanlin ;
Wang, Liang .
FRONTIERS IN NEUROLOGY, 2023, 14
[43]   A rare case report of concurrent cryptococcal, streptococcal, and tuberculous meningitis in a patient with pulmonary tuberculosis [J].
Bi, Dewu ;
Luo, Xiaolu ;
Tang, Xike ;
Luo, Xiaocheng ;
Mo, Lida .
MEDICINE, 2024, 103 (43) :e40276
[44]   Thalidomide in the treatment of human immunodeficiency virus-negative tuberculous meningitis A case report [J].
Liu, Ping ;
Pei, Ning ;
Liu, Xuhui ;
Huang, Wei ;
Lu, Shuihua .
MEDICINE, 2020, 99 (40) :E22639
[45]   A Case of Tuberculous Meningitis with Atypical Multiple Lesions [J].
Zhang, W. ;
Hu, Z. ;
Li, T. .
WEST INDIAN MEDICAL JOURNAL, 2014, 63 (07) :788-790
[46]   Case report: Successful treatment with contezolid in a patient with tuberculous meningitis who was intolerant to linezolid [J].
Xu, Zhe ;
Zhang, Jing ;
Guan, Tingting ;
Wan, Guichuan ;
Jiang, Chao ;
Lang, Linchuan ;
Wang, Lianzhi .
FRONTIERS IN MEDICINE, 2023, 10
[47]   Paradoxical improvement of function more than 2 years after onset of tuberculous meningitis [J].
Wilson, Barbara A. ;
Hinchcliffe, Angela ;
Tunnard, Catherine ;
Kapur, Narinder ;
Florschutz, Gerhard .
BRAIN INJURY, 2013, 27 (7-8) :944-950
[48]   A case of bilateral thalamic infarct complicating tuberculous meningoencephalitis [J].
Aasfara, Jehanne ;
Regragui, Wafa ;
El Ouardi, Loubna ;
Ben Haddou, El Hachmia Ait ;
Benomar, Ali ;
Yahyaoui, Mohammed .
PAN AFRICAN MEDICAL JOURNAL, 2019, 33
[49]   The challenge of differentiating tuberculous meningitis from bacterial meningitis [J].
Kurihara, Momoko ;
Kuroki, Tomonori ;
Nomura, Yushi ;
Katsube, Otohiro ;
Umetsu, Takafumi ;
Numao, Toshio ;
Shimizu, Taro ;
Sugiyama, Kumiya .
RESPIROLOGY CASE REPORTS, 2022, 10 (03)
[50]   Urine retention as presenting manifestation of tuberculous meningitis complicated by lacunar infarction and transverse myelitis: Case report and literature review [J].
Abdulhadi, Ahmed Salih ;
Abdelmahmuod, Elabbass A. ;
Al-Rubaiei, Jawaher ;
Ali, Elrazi ;
Mahfouz, Ahmed Emad ;
Farooqi, Amer .
CLINICAL CASE REPORTS, 2021, 9 (07)