Bacteriologically Confirmed Neuromeningeal Tuberculosis at the Hubert Koutoukou Maga National Hospital and University Center in Cotonou: About Two Cases Study and a Review of the Literature

• 作者: Angèle Azon-Kouanou Delphin Murhula Djimon Marcel Zannou Eugénie Dansou Fabien Fabien Kouessi Anthelme Agbodande Leoubou Roger Samuel Dodo Mahoutin Semassa Ghislain Missiho Marius Doukpo Roberto Dossou Torès Kouassi Prudencio Thomas Lokossou
• 来源期刊: 内科学期刊(英文)
• 学科: 医学
• 关键词: Neuromeningeal Tuberculosis HIV Infection DEATH Cotonou
• 年，卷（期）: 2020,（2）
• 页码范围: 190-197
• 页数: 8页
• 分类号: R73

摘要

Introduction: Tuberculosis remains a major public health problem. The damage to the central nervous system is severe. We reported here two cases. Clinical Case 1: A 37-year-old female patient, naively Human Immunodeficiency Virus1 (HIV1)-positive with antiretroviral (ARV) treatment, hospitalized in the Internal Medicine department for altered consciousness in a febrile context. The clinical examination at admission noted a meningeal syndrome. Cytological analysis of the cerebrospinal fluid (CSF) revealed lymphocytic meningitis with 98% lymphocytes for 3634 leukocytes. CSF polymerase chain reaction (PCR) detected <i>Mycobacterium tuberculosis</i> DNA. She was put on anti-tuberculosis treatment. The immediate course was favourable, but a secondary worsening of the clinical picture was the cause of his death. Clinical Case 2: A 34-year-old male patient, naively HIV1-positive with ARV treatment. He is hospitalized in the Multi-Purpose Anaesthesia and Resuscitation Department of the CNHU HKM for altered consciousness in a feverish context. The clinical examination noted a meningeal syndrome. The cytological analysis of the CSF noted 184 leukocytes for 99% lymphocytes. The CSF PCR identified the DNA of <i>Mycobacterium tuberculosis</i>. He was put on anti-tuberculosis treatment. The evolution was marked by his death. Conclusion: The neuromeningeal localization of tuberculosis is a poor prognosis. Co-infection with HIV remains a potential deadly combination.