Tuberculous meningitis

Case contributed by Dr Brendon Friesen

Presentation

Seizure

Patient Data

Age: 7 months
Gender: Female
X-ray

Left hilar mass compressing left main bronchus.

CT

Diffuse mediastinal and hilar lymphadenopathy.  Left upper lobe consolidation.

MRI

MRI:

Linear enhancement along anterior surface of brainstem. 

Mild ventriculomegaly.

No intracranial mass or collection.

No diffusion restriction or susceptibility artefact (not shown).

Ultrasound

Cranial ultrasound: increased pial echogenicity.

Case Discussion

Imaging features compatible with TB meningitis and pulmonary tuberculosis.

 

CSF MICROSCOPY & CULTURE

Macroscopic Appearance Clear and colourless

Cell Count

Polymorphs: 6 x 10^6/L

Lymphocytes: 56 x 10^6/L  

Total WCC: 62 x 10^6/L (0-5 x10^6/L)  (0-5 x10^6/L)

Red Blood cells: 8 x 10^6/L

Cryptococcal Antigen Not detected

Chemistry

Protein: 1.3 g/L (0.1-0.3)

Glucose: 1.1 mmol/L (2.5-5.0)

Lactate: 4.5 mmol/L (0-3.0)

Gram Stain No organisms seen

 

PCR negative for TB.

TB culture pending.

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Case information

rID: 28878
Case created: 18th Apr 2014
Last edited: 7th Oct 2015
System: Paediatrics
Inclusion in quiz mode: Included

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