Tuberculous Meningitis Presenting with Sudden Deterioration and Demise after Ceftriaxone Withdrawal: A Case Report and Review of Literature
Published: September 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/42345.13165
Francis Ikechukwu Ukekwe, Ann Ebele Aronu, Isaiah Ogbonna Nwidenyi, Ngozi Chinyelu Ojinnaka
1. Senior Lecturer/Consultant Pathologist, Department of Morbid Anatomy, University of Nigeria, Enugu Campus, Enugu/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
2. Senior Lecturer/Consultant Paediatrician, Department of Paediatrics, University of Nigeria, Enugu Campus, Enugu/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
3. Senior Registrar, Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
4. Professor/Consultant Paediatrician, Department of Paediatrics, University of Nigeria, Enugu Campus, Enugu/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Correspondence
Dr. Francis Ikechukwu Ukekwe,
Department of Morbid Anatomy, University of Nigeria, Enugu Campus (UNEC), P. M. B. 01129, Enugu-400241, Ituku-Ozalla, Enugu State, Nigeria.
E-mail: drikukekwe@hotmail.com
Tuberculous Meningitis (TBM) is a challenging condition to diagnose due to its non-specific clinical presentation and the limited sensitivity of existing laboratory techniques. Here we report an unusual presentation of TBM in a Nigerian teenager who presented with fever, headache, neck stiffness and progressive weight loss, and who had remarkable improvement while on ceftriaxone but had sudden deterioration and demise on withdrawal of ceftriaxone. Postmortem findings of TBM underlie the need for a high index of suspicion to enable early diagnosis, proper treatment and better prognosis.
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