TITLE:
Ischemic Stroke Complicating Neuromeningeal and Pulmonary Tuberculosis in Children: About a Case in Senegal
AUTHORS:
Papa Souleye Sow, Khadim Bop, Khalifa Ababacar Mbaye, Guillaye Diagne, Pape Malick Dibor Diouf, Idrissa Demba Ba, Papa Moctar Faye, Amadou Lamine Fall, Ousmane Ndiaye
KEYWORDS:
Tuberculosis, Meningitis, Child, Senegal
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.1,
January
16,
2023
ABSTRACT: Tuberculosis
is a major public health problem, especially in developing countries.
Neuro-meningeal involvement is rare but represents one of the most severe forms
with high morbidity and mortality. We report the case of an ischemic stroke
complicating neuromeningeal and pulmonary tuberculosis in a four-month-old
infant at the National Hospital Center of children Albert Royer (Senegal). The
case was a four-month-old, male infant with no history. His vaccination was up
to date according to Senegal’s expanded vaccination program. There was no
notion of tuberculosis contagion. He was seen for a prolonged fever for more
than a month and chronic cough. He had moderate malnutrition. Neurological
examination revealed coma, meningeal syndrome, generalized tonic convulsions
and hypertonia. The pupils were in bilateral miosis. Osteotendinous reflexes
were abolished with a bilateral Babinski sign. He also had severe respiratory
distress, bilateral pulmonary condensation syndrome. Brain computed tomography
was in favor of an ischemic stroke. The test GeneXpert MTB/RIF was positive on
cerebrospinal fluid and gastric tubing fluid. The curative treatment was based
on a quadruple therapy based on rifampicin, isoniazid, pirazinamide and
ethambutol. The evolution was unfavorable with the death of the patient.