Acta Scientific Microbiology (ISSN: 2581-3226)

Case Report Volume 4 Issue 12

Central Nervous System Vasculitis Due to Tuberculous Meningitis in A 23-year-old Adult with Pharmacological Immunosuppression

Francisco Javier Rivas-Ruvalcaba, Melissa Hernández-Vega, Arturo González-Lara and Ildefonso Rodríguez-Leyva*

Neurology Service, Hospital Central "Dr. Ignacio Morones Prieto" and Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Venustiano Carranza, Los Filtros, San Luis Potosí, San Luis Potosí, México

*Corresponding Author: Ildefonso Rodríguez-Leyva, Head Neurology Service, Hospital Central "Dr. Ignacio Morones Prieto" and Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Venustiano Carranza, Los Filtros, San Luis Potosí, San Luis Potosí, México.

Received: November 05, 2021 ; Published: November 24, 2021

Abstract

We present a 23-year-old man with a history of ankylosing spondylitis treated with methotrexate and sulfasalazine presented to the emergency room with a headache and a history of night sweats and weight loss. On a physical examination, he was drowsy, had dysmetria on his left hand and positive meningeal signs. In addition, the lumbar puncture had a positive PCR for Mycobacterium tuberculosis, so he was managed with rifampin, ethambutol, pyrazinamide, isoniazid and dexamethasone and was discharged. After the discharge, he was readmitted because he experienced acute dysarthria, and an MRI showed evidence of an ischemic stroke with findings suggestive of central nervous system vasculitis. After initiation of secondary prophylaxis and high dose steroid, he was discharged and could stand up by himself and had partial recovery of dysarthria.

Keywords: Pyrazinamide; Tuberculous Meningitis; Immunosuppression

References

  1. World Health Organization – tuberculosis.
  2. van de Beek D., et al. “Community-acquired bacterial meningitis”. Nature Reviews Disease Primers2 (2016): 16074.
  3. McGill F., et al. “Acute bacterial meningitis in adults”. Lancet10063 (2016): 3036-3047.
  4. Mada PK., et al. “Cryptococcus”. En: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing (2021).
  5. Elhariri M., et al. “Eucalyptus Tree: A Potential Source of Cryptococcus neoformans in Egyptian Environment”. International Journal of Microbiology 2016 (2016): 4080725.
  6. Sloan DJ and Parris V. “Cryptococcal meningitis: epidemiology and therapeutic options”. Clinical Epidemiology 6 (2014): 169-182.
  7. Younger DS and Coyle PK. “Central Nervous System Vasculitis due to infection”. Neurology Clinic2 (2019): 441-463.
  8. Recommendations | tuberculosis | guidance | NICE (2021).
  9. Prasad K., et al. “Corticosteroids for managing tuberculous meningitis”. Cochrane Database of Systematic Reviews 4 (2016): CD002244.
  10. Tai M-LS., et al. “Cerebral infarction pattern in tuberculous meningitis”. Scientific Reports1 (2016).
  11. Katrak SM. “Vasculitis and stroke due to tuberculosis”. In: Caplan LR, Bogousslavsky J, editors. Uncommon Causes of Stroke. 2nd ed. Cambridge: Cambridge University Press (2008): 41-46.

Citation

Citation: Ildefonso Rodríguez-Leyva., et al. “Central Nervous System Vasculitis Due to Tuberculous Meningitis in A 23-year-old Adult with Pharmacological Immunosuppression”. Acta Scientific Microbiology 4.12 (2021): 75-78.

Copyright

Copyright: © 2021 Ildefonso Rodríguez-Leyva., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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