Miliary tuberculosis with meningovascular involvement

• Autores: Mesía-Ángeles, Diego, Simon-Lagos, Pilar, Cuti-Simon, Félix E., Navarro- Yparraguirre, Madelaine, Medina-Soriano, Carlos
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Sociedad Peruana de Medicina Interna
• Repositorio: Revista de la Sociedad Peruana de Medicina Interna
• Lenguaje: español
• OAI Identifier: oai:medicinainterna.net.pe:article/781
• Enlace del recurso: https://revistamedicinainterna.net/index.php/spmi/article/view/781
• Nivel de acceso: acceso abierto
• Materia: Tuberculosis miliar; Tuberculosis delsistema nervioso central; uberculosis resistente a múltiples drogas; milliary tuberculosis; Central nervous system tuberculosis; Multidrug-resistant tuberculosis

The case of a 20-year-old male patient is presented, with an illness of one week characterized by asthenia, hyporexia, nausea, vomiting, neck stiffness, intermittent headache of intensity 9/10, fever quantified at 38.5. °C, scant dry cough, weight loss and left hemiparesis without loss of consciousness. Serological tests, including HIV, were negative. The spinal fluid showed pleocytosis with a predominance of mononuclear cells, hyperproteinorrachia and hypoglycorrhachia, with a positive GeneXpert MTB/RIF test for M. tuberculosis resistant to rifampicin, in addition to a positive sputum smear for the same germ. The images showed a miliary pattern and vascular compromise (bilateral hypodensities at the level of the basal ganglia and internal capsule). He was treated as multidrug-resistant systemic tuberculosis with a favorable outcome.