Complicated Neurotuberculosis with sinus venous thrombosis: A case-report

Yousra Ali; Yahia Imam; Hasan S Ahmedullah; Naveed Akhtar; Saadat Kamran; Muna Al Maslmani; A Latif Al Khal; Ahmed Own; Dirk Deleu

doi:10.1016/j.idcr.2022.e01374

Complicated Neurotuberculosis with sinus venous thrombosis: A case-report

IDCases. 2022 Jan 3:27:e01374. doi: 10.1016/j.idcr.2022.e01374. eCollection 2022.

Authors

Yousra Ali¹, Yahia Imam^{2

3}, Hasan S Ahmedullah⁴, Naveed Akhtar^{2

3}, Saadat Kamran^{2

3}, Muna Al Maslmani^{3

4}, A Latif Al Khal^{3

4}, Ahmed Own², Dirk Deleu^{2

3}

Affiliations

¹ Department of Medicine, Hamad Medical Corporation Doha, Qatar.
² Neuroscience Institute, Hamad Medical Corporation Doha, Qatar.
³ Weil Cornell Medicine, Doha, Qatar.
⁴ Center for Communicable Disease, Doha, Qatar.

Abstract

Introduction: Neurotuberculosis comprises around 6% of systemic tuberculosis. It targets a younger population, and it often leads to severe neurological complications or death.

Case report: We report a young gentleman with a clinically defined tuberculous meningitis (TBM) and multiple neurological complication associated with TBM occurring simultaneously. This includes hydrocephalus requiring a ventriculoperitoneal shunt, vasculitic infarcts, cranial nerve palsies, TB granuloma and cerebral venous thrombosis. The cerebrospinal fluid polymerase chain reaction for tuberculosis as well as cultures remained negative repeatedly. The patient was treated with anti-tuberculous medication in addition to steroids based on validated scoring systems suggestive of TBM and made a good recovery.

Conclusion: This report highlights the different complication seen with TBM and the importance of using clinical criteria to guide management plan particularly when cultures are negative.

Keywords: Cerebral venous thrombosis; Cranial nerve palsies; Culture negative; Hydrocephalus; Infarcts; Neurotuberculosis; TB granuloma; Tuberculous meningitis.

Publication types

Case Reports