Meningotuberculosis in infant: a case report

Abstract

Introduction: Tuberculosis caused by Mycobacterium tuberculosis is one of the top 10 causes of death among children worldwide. Objective: To report the case of a nursling with meningotuberculosis with good recovery, to inquire about the treatment of latent infection in infants after contact with tuberculosis and to observe data that lead to the early diagnosis of meningotuberculosis, avoiding sequelae of the disease. Case report: We therefore report a case of a 9-month-old infant with a concomitant mother’s treatment for pulmonary tuberculosis for 5 months, with supervised doses. Patient had been investigated for latent infection, excluding hypothesis; he had his vaccination up to date. Initially, treatment for bacterial meningitis was performed but due to worsening of general condition, change in cerebrospinal fluid, hypertensive hydrocephalus on skull tomography, associated with family history, we began treatment for tuberculous meningitis, with a good response. Comments: Tuberculous meningoencephalitis, despite being one of the main causes of infant mortality, is still a neglected disease. Diagnostic methods are not yet very effective and therefore a number of clinical, laboratory and anamnesis parameters should be taken into account for treatment to be started as soon as possible. The Ministry of Health recommends the use of rifampicin, pyrazinamide and isoniazid as a treatment for children younger than 10 years old in association with corticosteroids. Due to the disease severity and its suboptimal diagnostic capacity, the priority should still be prevention, either through vaccination or screening for latent infection.