Ischemic cerebrovascular accident associated with bacillary meningoencephalitis in patients with HIV
Keywords:
TUBERCULOSIS, MENINGEAL, AIDS SERODIAGNOSIS, AIDS-RELATED OPPORTUNISTIC INFECTIONS, STROKE, MENINGOENCEPHALITISAbstract
Tuberculous meningitis is difficult to be diagnosed, it is not important according to morbidity, but it does have a high mortality rate among the affected people. Cerebral infarction occurs in a significant percentage of the patients with tuberculous meningitis. This study presents the case of a 25-year-old male patient with a diagnosis of HIV with a 9-year progress, who visited the office due to clinical manifestations of repeated vomits. Laboratory and radiological studies were ordered. The patient was admitted with a probable diagnosis of a convulsive syndrome to be determined, bacillary meningoencephalitis, probable progressive multifocal leukoencephalopathy and C3 retrovirus. A cerebrovascular accident is later confirmed with bacillary meningoencephalitis. After 4 months of treatment and a constant follow-up the positive progress of the patient was verified.Downloads
References
Merkler AE, Reynolds AS, Gialdini G, Morris NA, Murthy SB, Thakur K, et al. Neurological complications after tuberculous meningitis in a multi-state cohort in the United States. J Neurol Sci [revista en internet]. 2017 [citado 10 de abril 2017]; 375: 460-463. Disponible en: doi: 10.1016/j.jns.2017.02.051.
Pormohammad A, Riahi SM, Nasiri MJ, Fallah F, Aghazadeh M, Doustdar F, et al. Diagnostic test accuracy of adenosine deaminase for tuberculous meningitis: A systematic review and meta-analysis. J Infect [revista en internet]. 2017 [citado 10 de abril 2017]; 74(6): 545-554. Disponible en: doi: 10.1016/j.jinf. 2017.02.012.
Wilkinson RJ, Rohlwink U, Misra UK, van Crevel R, Mai NTH, Dooley KE, et al. Tuberculous meningitis. Nat Rev Neurol [revista en internet]. 2017 [citado 10 de abril 2017]; 13(10): 581-598. Disponible en: doi: 10.1038/nrneurol.2017.120.
Gualberto FAS, Gonçalves MG, Fukasawa LO, Santos AMRD, Sacchi CT, Harrison LH, et al. Performance of nested RT-PCR on CSF for tuberculous meningitis diagnosis in HIV-infected patients. The International Journal of Tuberculosis and Lung Disease [revista en internet]. 2017 [citado 10 de abril 2017]; 21(10): 1139-1144. Disponible en: http://www.ingentaconnect.com/contentone/iuatld/ijtld/2017/00000021/00000010/ art00014.
Organización Mundial de la Salud (OMS).Global Tuberculosis Report. NLM classification: WF 300, (2016). Disponible en: http://apps.who.int/medicinedocs/documents/s23098en/s23098en.pdf.
Bowen LN, Smith B, Reich D, Quezado M, Nath A. HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment. Nat Rev Neurol [revista en internet]. 2016 [citado 10 de abril 2017]; 12(11): 662-674. Disponible en: doi: 10.1038/nrneurol.2016.
Misra UK, Kalita J, Maurya PK. Stroke in tuberculous meningitis. J Neurol Sci [revista en internet]. 2011 [citado 10 de abril 2017]; 303(1): 22–30. Disponible en: http://www.sciencedirect.com/science/article/pii/S 0022510X10006386.
Hsieh FY, Chia LG, Shen WC. Locations of cerebral infarctions in tuberculous meningitis. Neuroradiology [revista en internet]. 1992 [citado 10 de abril 2017]; 34(3): 197–199. Disponible en: http://www.springerlink.com/index/U07M42887551U626.pdf.
Aguilar G, Ríos-González CM, Samudio T, Kawabata A. Características epidemiológicas de la infección por VIH en Paraguay durante el año 2015. Rev. chil. infectol [revista en internet]. 2017 [citado 10 de abril 2017]; 34(4): 415-416. Disponible en: http://dx.doi.org/10.4067/s0716-10182017000400415.
Rios-González CM. Importancia de la oferta de tamizaje del VIH en Paraguay. CIMEL [revista en internet]. 2017 [citado 10 de abril 2017]; 22(2). Disponible en: doi:10.23961/cimel.2017.222.779.
World Health Organisation. Tuberculosis, March. Fact sheet N°104, (2014). Disponible en: http://www.who. int/mediacentre/factsheets/fs104/en/.
Lee HG, William T, Menon J, Ralph AP, Ooi EE, Hou Y, et al. Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study. BMC Infect Dis [revista en internet]. 2016 [citado 10 de abril 2017]; 16(1): 296. Disponible en: doi: 10.1186/s12879-016-1640-x.
Qu J, Zhou T, Zhong C, Deng R, Lü X. Comparison of clinical features and prognostic factors in HIV-negative adults with cryptococcal meningitis and tuberculous meningitis: a retrospective study. BMC Infect Dis [revista en internet]. 2013 [citado 10 de abril 2017]; 52(14): 1573-8. Disponible en: https://www.jstage.jst. go.jp/article/internalmedicine/52/14/52_52.0168/_article/-char/ja/.
Pyrgos V, Seitz AE, Steiner CA, Prevots DR, Williamson PR. Epidemiology of cryptococcal meningitis in the US: 1997-2009. PLoS One [revista en internet]. 2013 [citado 10 de abril 2017]; 8(2): e56269. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23457543.
Yuchong C, Fubin C, Jianghan C, Fenglian W, Nan X, Minghui Y, et al. Cryptococcosis in China (1985-2010): review of cases from Chinese database. Mycopathologia [revista en internet]. 2012 [citado 10 de abril 2017]; 173(5-6): 329-35. Disponible en: http://link.springer.com/article/10.1007/s11046-011-9471-1.
Gu J, Xiao H, Wu F, Ge Y, Ma J, Sun W. Prognostic factors of tuberculous meningitis: a single-center study. Int J Clin Exp Med [revista en internet]. 2015 [citado 10 de abril 2017]; 8(3): 4487-93. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443207/.
Zhang B, Lv K, Bao J, Lu C, Lu Z. Clinical and laboratory factors in the differential diagnosis of tuberculous and cryptococcal meningitis in adult HIV-negative patients. Intern Med [revista en internet]. 2013 [citado 10 de abril 2017]; 52(14): 1573-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23857088.
WHO. Global tuberculosis report 2014. World Health Organization, Geneva; 2014.
WHO. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculous in adults and children. Policy update. World Health Organization, Geneva; 2013.
Denkinger CM, Schumacher SG, Boehme CC, Dendukuri N, Pai M, Steingart KR. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. Eur Respir J [revista en internet]. 2014 [citado 10 de abril 2017]; 44(2): 435–446. Disponible en: http://erj.ersjournals.com/ content/44/2/435.short.
Thwaites GE, van Toorn R, Schoeman J. Tuberculous meningitis: more questions, still too few answers. Lancet Neurol [revista en internet]. 2013 [citado 10 de abril 2017]; 12(10): 999-1010. Disponible en: http://www.sciencedirect.com/science/article/pii/S1474442213701686.
Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis [revista en internet]. 2010 [citado 10 de abril 2017]; 50(3): 291-322. Disponible en: https://academic.oup.com/cid/article-abstract/50/3/291/392360.
Wilcox RA, Thyagarajan D, Kempster P. Two cases of Cryptococcus meningitis presenting as leukoencephalopathy prior to amphotericin therapy. Eur J Neurol [revista en internet]. 2007 [citado 10 de abril 2017]; 14(3): 350-2. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2006.01561.x/ full.
Gordon A, Parsons M. The place of corticosteroids in the management of tuberculous meningitis. Br J Hosp Med. 1972; 7(65).
Lasso B M. Meningitis tuberculosa: claves para su diagnóstico y propuestas terapéuticas. Rev. chil. infectol [revista en internet]. 2011, Jun [citado 10 de abril 2017]; 28(3): 238-247. Disponible en: http://dx.doi.org/10.4067/S0716-10182011000300007.
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