Rosales-Magallanes GF

Language: Spanish
References: 13
Page: 222-225
PDF size: 241.01 Kb.

ABSTRACT

Introduction: Of the cases of tuberculosis in Mexico, 8.4% corresponds to children under 18 years of age. The risk of developing invasive disease is up to 24% in unvaccinated children under two years of age. The incidence of tuberculosis has increased in Baja California because of the high rate of migration, poverty and poor access to health services. We present the case of tuberculous meningitis in a non-vaccined-BCG infant. Case presentation: One year and eleven months old male, who lives in Mexicali, Baja California, born in the United States of America, son of migrants. Without BCG vaccination. No close contacts with tuberculosis were identified. Prior to hospitalization, the patient had intermittent fever and hyporexia in the past two months; he had admitted for persistent fever and a convulsive event. On physical examination: irritability, hyperreflexia and Babinski; in CSF cytochemistry: 10 cells/dL, cell predominance were lymphocytes, hyperproteinorrachia (219 mg/dL), glucose 30 mg/dL (glycaemia 75 mg); Gram stain and Ziehl Neelsen were negative. Vancomycin and ceftriaxone were started with poor evolution; at 48 h, hydrocephalus was detected and ventriculostomy was performed. Mycobacterium tuberculosis infection was suspected, so specific treatment was started. In MRI, basal arachnoiditis was observed. QuantiFERON TB Gold was positive. The patient completed antifungal treatment and survived with neurological sequelae. Conclusions. It is essential to suspect tuberculosis in children under five years of age with an incomplete vaccination scheme and other risk factors.

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