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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 24, No. 6, 2017, pp. 103-106
Bioline Code: mj17085
Full paper language: English
Document type: Case Report
Document available free of charge

Malaysian Journal of Medical Sciences, Vol. 24, No. 6, 2017, pp. 103-106

 en A Rare Presentation of Tubercular Meningitis as Persistent Neutrophilic Meningitis
Ralot, Tarun; Bafna, Chander; Singh, Surender & Sharma, Shubhkaran

Abstract

  Persistent neutrophilic meningitis is an atypical form of chronic meningitis defined as clinical meningitis with a cerebrospinal fluid (CSF) analysis suggestive of neutrophilic pleocytosis that persists for more than one week despite giving empirical antimicrobial therapy. The predominant presentation of tubercular meningitis is with CSF lymphocytic pleocytosis and even if early phase of the disease presents with neutrophilic pleocytosis, no persistence is usually observed for more than one week.   
We hereby report the case of an immunocompetent man aged 25 years with tubercular meningitis manifesting as persistent neutrophilic meningitis which is very rare as an entity in tubercular meningitis (TBM). Patient was started on anti-tubercular therapy based on the granulomas in magnetic resonance imaging (MRI) of the brain after which there was a reduction in total cell count in CSF but persisting neutrophilic predominance. Patient improved clinically and was given a full course of anti-tubercular treatment (ATT) thereafter.

Keywords
tubercular meningitis; anti-tubercular treatment; persistent neutrophilic meningitis; lymphocytic pleocytosis; lymphocytic pleocytosis; granulomas

 
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