Walsall Manor Hospital, UK
Scientific Tracks Abstracts: Clin Pediatr
Tuberculosis (TB) meningitis is the most severe manifestation of acute TB because morbidity and mortality are very high. Evidence suggests that Bacillus Calmette-Guerin (BCG) vaccination reduces the risk of disseminated TB however we present a case report of a 15-year old Bangladeshi girl who suffered from TB meningitis despite having had the BCG vaccination as a newborn but did not develop a scar. She was admitted with six weeks history of pyrexia, headaches and weight loss with no TB contacts or pulmonary signs. Her inflammatory markers were unremarkable and after an initial normal CT scan, her LP showed increased pressure of 40 cmHg. We drained 10 ml of CSF, which was clear and colorless with mildly raised protein of 0.98, glucose 1.2, RBC 1 and WBC 1. She was treated for acellular meningoencephalitis and TB workup was started. In the next 24 hours, her condition deteriorated with reduced GCS of 9-11. Her mantoux was strongly positive within 24 hours and she was started on anti TB medication. Repeated CT scan on day three, showed hydrocephalus and needed a ventricular drain insertion. CSF PCR and culture were positive for TB. GeneXpert claims to give a diagnosis within two hours for TB using gene PCR.
Muhammad Riaz has completed MBBS from Punjab Medical College, Faisalabad affiliated with Punjab University, Lahore Pakistan. He has completed fellowship training in Paediatrics from Pakistan and completed MRCPCH in 2013. Currently he is working in Walsall Manor Hospital in a middle grade position in the Paediatrics Department.