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Cerebral tuberculosis without meningitis in a immunocompetent child

Tuberculosis cerebral sin meningitis en un niño inmunocompetente

dc.contributoren-US
dc.contributores-ES
dc.creatorRamírez, Mónica
dc.creatorCortés, Eduardo
dc.creatorBetancur, José
dc.creatorGarcés, Carlos
dc.date2018-05-13
dc.date.accessioned2019-04-16T14:41:32Z
dc.date.available2019-04-16T14:41:32Z
dc.identifierhttp://revinf.cl/index.php/revinf/article/view/85
dc.identifier.urihttp://revistaschilenas.uchile.cl/handle/2250/40803
dc.descriptionCerebral tuberculosis TB (tuberculomas) without meningitis is an uncommon disease with a high morbidity and mortality. We report on a case that illustrates the complexity of this clinical presentation. An 11 month old, previously healthy male infant was brought to the clinic due to fever present during the last 1.5 months, associated with loss of neurodevelopmental goals and signs of endocranial hypertension. CT scan of the skull revealed dilatation of the ventricular system with transependimary edema; MRI showed multiple intra- and extra-axial micronodular images and hydrocephalus. Studies of CSF (cyto-chemical analysis, staining, culture for aerobes, fungi, mycobacteria, and molecular tests for TB were negative). Empirical management for subacute meningoencephalitis was prescribed complemented with tetraconjugated treatment for TB and steroids. As there was no microbiological isolation, biopsy of a cerebellar lesion was performed, which revealed chronic necrotizing granulomatous inflammation and acid-alcohol resistant bacilli. The diagnosis of cerebral TB without meningeal involvement was confirmed. The objective of the present report is to emphasize the importance of considering this presentation of TB in children, to remark the need of exhaustive search for the etiologic agent by obtaining samples of the different fluids and tissues even if it implies recurring to invasive methods.en-US
dc.descriptionLa tuberculosis (TBC) cerebral o tuberculoma(s) sin meningitis es una enfermedad poco frecuente y de alta morbimortalidad. Presentamos el caso clínico de un lactante de 11 meses, previamente sano, que consultó por fiebre prolongada y síntomas neurológicos. La RM de encéfalo mostró múltiples imágenes micronodulares e hidrocefalia. El estudio de LCR para bacterias, hongos y micobacterias fue negativo. Se prescribió terapia empírica como una meningoencefalitis subaguda y tratamiento antituberculoso tetraconjugado y corticoesteroides. La confirmación del diagnóstico de TBC cerebral se realizó por biopsia de la lesión, con presencia de inflamación granulomatosa crónica necrosante y bacilos ácido-alcohol resistentes. Se enfatiza la importancia de considerar esta presentación de TBC en niños, y la necesidad de la búsqueda exhaustiva del agente etiológico en diferentes líquidos y tejidos, aun por métodos invasores.es-ES
dc.format
dc.languagespa
dc.publisherSociedad Chilena de Infectologíaes-ES
dc.relationhttp://revinf.cl/index.php/revinf/article/view/85/54
dc.rightsCopyright (c) 2018 Revista Chilena de Infectologíaes-ES
dc.rightshttps://creativecommons.org/licenses/by-sa/4.0es-ES
dc.sourceRevista Chilena de Infectología; Vol. 35, Núm. 2 (2018): Abriles-ES
dc.source0717-6341
dc.source0716-1018
dc.subjectCerebral tuberculosis; central nervous system tuberculosis; tuberculomas; tuberculous meningitis; childrenen-US
dc.subjectTuberculosis cerebral; tuberculosis del sistema nervioso central; tuberculoma; meningitis tuberculosa; niñoses-ES
dc.titleCerebral tuberculosis without meningitis in a immunocompetent childen-US
dc.titleTuberculosis cerebral sin meningitis en un niño inmunocompetentees-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typees-ES
dc.typeen-US


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