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Tuberculous Meningitis in an Immunocompetent Host: A Case Report

Patient: Male, 57 Final Diagnosis: Tuberculous meningitis Symptoms: Altered mental state • headache Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Rare disease BACKGROUND: Tuberculous meningitis is very rare in the United States in immunocompetent hosts....

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Autores principales: Khanna, Suchin R., Kralovic, Stephen M., Prakash, Rajan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214229/
https://www.ncbi.nlm.nih.gov/pubmed/28008165
http://dx.doi.org/10.12659/AJCR.900762
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author Khanna, Suchin R.
Kralovic, Stephen M.
Prakash, Rajan
author_facet Khanna, Suchin R.
Kralovic, Stephen M.
Prakash, Rajan
author_sort Khanna, Suchin R.
collection PubMed
description Patient: Male, 57 Final Diagnosis: Tuberculous meningitis Symptoms: Altered mental state • headache Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Rare disease BACKGROUND: Tuberculous meningitis is very rare in the United States in immunocompetent hosts. Risk factors are similar to those of pulmonary tuberculosis, including poverty, malnutrition, overcrowding, a compromised immune system, and coming from an endemic area. Meningeal tuberculosis mortality and other outcomes have changed little over time despite effective therapies due to delay in diagnosis because of its rarity, variable presentation, and often indolent course. CASE REPORT: We describe a case of a 57-year-old male immigrant from Senegal with no significant past medical history and no previous history of tuberculosis or evidence of immune compromise. He presented to the hospital with headache and altered mental status and was subsequently diagnosed with tuberculous meningitis. CONCLUSIONS: This is a rare case of tuberculous meningitis in an immunocompetent host, questioning the conventional view that tuberculous meningitis is a disease of immunocompromised individuals. It emphasizes the importance of maintaining a strong clinical suspicion of tuberculous meningitis even in an immunocompetent patient in a geographical area with low prevalence if the patient has risk factors. Missed or delayed diagnosis is commonly fatal.
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spelling pubmed-52142292017-01-17 Tuberculous Meningitis in an Immunocompetent Host: A Case Report Khanna, Suchin R. Kralovic, Stephen M. Prakash, Rajan Am J Case Rep Articles Patient: Male, 57 Final Diagnosis: Tuberculous meningitis Symptoms: Altered mental state • headache Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Rare disease BACKGROUND: Tuberculous meningitis is very rare in the United States in immunocompetent hosts. Risk factors are similar to those of pulmonary tuberculosis, including poverty, malnutrition, overcrowding, a compromised immune system, and coming from an endemic area. Meningeal tuberculosis mortality and other outcomes have changed little over time despite effective therapies due to delay in diagnosis because of its rarity, variable presentation, and often indolent course. CASE REPORT: We describe a case of a 57-year-old male immigrant from Senegal with no significant past medical history and no previous history of tuberculosis or evidence of immune compromise. He presented to the hospital with headache and altered mental status and was subsequently diagnosed with tuberculous meningitis. CONCLUSIONS: This is a rare case of tuberculous meningitis in an immunocompetent host, questioning the conventional view that tuberculous meningitis is a disease of immunocompromised individuals. It emphasizes the importance of maintaining a strong clinical suspicion of tuberculous meningitis even in an immunocompetent patient in a geographical area with low prevalence if the patient has risk factors. Missed or delayed diagnosis is commonly fatal. International Scientific Literature, Inc. 2016-12-23 /pmc/articles/PMC5214229/ /pubmed/28008165 http://dx.doi.org/10.12659/AJCR.900762 Text en © Am J Case Rep, 2016 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
spellingShingle Articles
Khanna, Suchin R.
Kralovic, Stephen M.
Prakash, Rajan
Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title_full Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title_fullStr Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title_full_unstemmed Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title_short Tuberculous Meningitis in an Immunocompetent Host: A Case Report
title_sort tuberculous meningitis in an immunocompetent host: a case report
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214229/
https://www.ncbi.nlm.nih.gov/pubmed/28008165
http://dx.doi.org/10.12659/AJCR.900762
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