Stroke in a patient with tuberculous meningitis and HIV infection

Maria Bruna Pasticci, Maurizio Paciaroni, Piero Floridi, Enisia Cecchini, Franco Baldelli
  • Maurizio Paciaroni
    University of Perugia, Perugia, Italy
  • Piero Floridi
    Ospedale Santa Maria della Misericordia, Perugia, Italy
  • Enisia Cecchini
    University of Perugia, Perugia, Italy
  • Franco Baldelli
    University of Perugia, Perugia, Italy

Abstract

Abstract. Tuberculous meningitis (TBM) is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

Keywords

Mycobacterium tuberculosis, meningitis, stroke, HIV co-infection

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Submitted: 2014-06-13 10:00:04
Published: 2013-02-18 00:00:00
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