Simona Claudia Cambrea 1, Claudia Nina Rugină 2, Clementina Urjan 3, E. Vasiliu 4, S. Rugină 1
1 Infectious Diseases Clinic, Faculty of Medicine, “Ovidius” University Constanţa, Romania
2 Clinical Laboratory, Clinical Infectious Diseases Hospital of Constanţa, Romania
3 MRI/CT Department, Euromedic Constanţa, Romania
4 Pneumophtiziology Ambulatory, Pneumology Hospital of Constanţa, Romania
Abstract
Tuberculous involvement of the central nervous system (CNS) is an important and serious type of extra-pulmonary involvement. It has been estimated that approximately 10% of all patients with TB have CNS involvement. Th e incidence of CNS tuberculosis is directly proportional to the prevalence of tuberculous infection in general. In developing countries CNS tuberculosis is a disease of younger age group, usually childhood. The high morbidity and mortality of tuberculous meningoencephalitis (TBM) warrants an early diagnosis and treatment. In Constanta County in the fi rst 3 months of the year 2007 we noticed the presence of 5 cases of TBM in children with ages ranging from 6 months to 6 years. In Romania BCG vaccine is mandatory and it has been proven to reduce the incidence of severe disseminated disease in children. In this context we report a case of TB meningoencephalitis (TBM), in a 2 years and 3 months old metiss child without BCG vaccine. We analyze the aspect of cerebrospinal fluids, electroencephalography (EEG), infl ammatory blood tests and cerebral MRI examination. Diagnosis of TBM was delayed in this case. In the fi rst month of treatment the child presented a toxic hepatitis due to antituberculosis treatment. Hydrocephaly was present at the onset of the disease. In evolution, we noticed transient decrease of visual acuity, cranial nerve paralysis, and severe motor deficit.