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Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer

INTRODUCTION: Tuberculous meningitis is rare but one of the most severe forms of tuberculosis infection. CASE REPORT: A 78-year-old woman was diagnosed with advanced gastric cancer with multiple lymph node metastases. Four months after the beginning of second-line chemotherapy with weekly paclitaxel...

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Autores principales: Matsumoto, Hiroshi, Sasaki, Akinori, Nakamura, Yoshiaki, Kawazoe, Akihito, Kuboki, Yasutoshi, Okinaka, Keiji, Shitara, Kohei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968297/
https://www.ncbi.nlm.nih.gov/pubmed/29805373
http://dx.doi.org/10.1159/000488313
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author Matsumoto, Hiroshi
Sasaki, Akinori
Nakamura, Yoshiaki
Kawazoe, Akihito
Kuboki, Yasutoshi
Okinaka, Keiji
Shitara, Kohei
author_facet Matsumoto, Hiroshi
Sasaki, Akinori
Nakamura, Yoshiaki
Kawazoe, Akihito
Kuboki, Yasutoshi
Okinaka, Keiji
Shitara, Kohei
author_sort Matsumoto, Hiroshi
collection PubMed
description INTRODUCTION: Tuberculous meningitis is rare but one of the most severe forms of tuberculosis infection. CASE REPORT: A 78-year-old woman was diagnosed with advanced gastric cancer with multiple lymph node metastases. Four months after the beginning of second-line chemotherapy with weekly paclitaxel, she was admitted to our hospital because of fever and mild drowsiness. She had no other symptoms and no abnormalities in physical examinations. Her blood tests, urinalysis, and blood culture revealed no remarkable abnormal findings. Although her symptoms relieved, her disturbance of consciousness gradually progressed during 2 weeks thereafter. Finally, we diagnosed tuberculous meningitis on the 22nd day of hospitalization by a positive acid-fast bacilli test of the cerebrospinal fluid and tuberculosis-polymerase chain reaction. Although anti-tuberculosis therapy was started, she died on the 37th day of hospitalization because of tumor bleeding. CONCLUSION: To the best of our knowledge, this is the first report of tuberculous meningitis during chemotherapy for advanced gastric cancer, suggesting that subacute onset of fever followed by disturbance of consciousness may indicate the possibility of tuberculous meningitis even without typical signs of meningitis including headache or meningeal irritation.
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spelling pubmed-59682972018-05-25 Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer Matsumoto, Hiroshi Sasaki, Akinori Nakamura, Yoshiaki Kawazoe, Akihito Kuboki, Yasutoshi Okinaka, Keiji Shitara, Kohei Case Rep Oncol Case Report INTRODUCTION: Tuberculous meningitis is rare but one of the most severe forms of tuberculosis infection. CASE REPORT: A 78-year-old woman was diagnosed with advanced gastric cancer with multiple lymph node metastases. Four months after the beginning of second-line chemotherapy with weekly paclitaxel, she was admitted to our hospital because of fever and mild drowsiness. She had no other symptoms and no abnormalities in physical examinations. Her blood tests, urinalysis, and blood culture revealed no remarkable abnormal findings. Although her symptoms relieved, her disturbance of consciousness gradually progressed during 2 weeks thereafter. Finally, we diagnosed tuberculous meningitis on the 22nd day of hospitalization by a positive acid-fast bacilli test of the cerebrospinal fluid and tuberculosis-polymerase chain reaction. Although anti-tuberculosis therapy was started, she died on the 37th day of hospitalization because of tumor bleeding. CONCLUSION: To the best of our knowledge, this is the first report of tuberculous meningitis during chemotherapy for advanced gastric cancer, suggesting that subacute onset of fever followed by disturbance of consciousness may indicate the possibility of tuberculous meningitis even without typical signs of meningitis including headache or meningeal irritation. S. Karger AG 2018-04-05 /pmc/articles/PMC5968297/ /pubmed/29805373 http://dx.doi.org/10.1159/000488313 Text en Copyright © 2018 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Matsumoto, Hiroshi
Sasaki, Akinori
Nakamura, Yoshiaki
Kawazoe, Akihito
Kuboki, Yasutoshi
Okinaka, Keiji
Shitara, Kohei
Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title_full Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title_fullStr Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title_full_unstemmed Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title_short Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
title_sort tuberculous meningitis during chemotherapy for advanced gastric cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968297/
https://www.ncbi.nlm.nih.gov/pubmed/29805373
http://dx.doi.org/10.1159/000488313
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