Ischemic stroke and disseminated tuberculosis in a child living with human immunodeficiency virus: a case report and review of the literature

BACKGROUND: Cerebrovascular accidents are rare in children. Rates of stroke in children with human immunodeficiency virus infection are higher than in the uninfected population. CASE PRESENTATION: We report the case of a 19-month-old Ethiopian boy who presented with a left-sided body weakness of sudden onset. He was also diagnosed as having human immunodeficiency virus infection. Laboratory tests showed an iron deficiency anemia and imaging revealed tuberculosis of his lungs, spleen, and abdominal lymph nodes as well as an acute ischemic stroke of the right middle cerebral artery region. His symptoms improved after anti-tuberculosis drugs, antiretroviral treatment, and iron supplementation were initiated. CONCLUSIONS: Extrapulmonary tuberculosis should be considered a cause of sudden focal neurologic deficits in children with human immunodeficiency virus infection residing in endemic countries.