Respir Case Rep. 2017; 6(1): 5-11 | DOI: 10.5505/respircase.2017.70783

Tuberculous Meningitis in Two-Year-Old Male Boy: Evidence of Recent Transmission from Mother to Baby

Shital PATIL¹, Nilesh Nagargoje², C. R. Choudhary^3
1Department of Pulmonary Medicine, MIMSR Medical College, Latur, Maharashtra, India
²Department of Internal Medicine, Government Medical College, Latur, Maharashtra, India
³Department of Pulmonary Medicine, Dr. S.N. Medical College, Latur, Maharashtra, India

Tuberculous (TB) meningitis is the commonest in-fectious disease of central nervous system in pediatric and geriatric cases. Tuberculosis can be prevented in children by diagnosing and treating cases of active TB amongst adults, as pediatric cases always acquire it passively from household contact of adults suffering from TB as disease in adults is multibacillary. Although significant data is available for the prevention of childhood extra-pulmonary and disseminated TB, offering them Bacillus Calmette-Guerin (BCG) vaccination, it is still not routinely offered during vaccination. In this case report, a two-year child with a history of failure to thrive and constitutional symptoms diagnosed with disseminated extra-pulmonary TB presenting as TB meningitis with a history of contact with the mother suffering from active sputum positive pulmonary TB receiving anti-TB treatment. In conclusion, we recommend BCG vaccination to all newborns, and tuberculin skin testing and isoniazid prophylaxis to the contact of adults with sputum positive pulmo-nary TB cases in India.

Keywords: Tuberculous meningitis, BCG Vaccination, isoniazid, tuberculin skin test, recent transmission, mother to child

---

Anneden Çocuða Bulaþmanýn Kanýtý Olarak Tüberküloz Menenjitli Ýki Yaþýnda Erkek Çocuk

Shital PATIL¹, Nilesh Nagargoje², C. R. Choudhary^3
1MIMSR Týp Fakültesi, Göðüs Hastalýklarý AD, Latur, Maharaþtra, Hindistan
²Devlet Týp Fakültesi, Ýç Hastalýklarý AD, Latur, Maharaþtra, Hindistan
³Dr. S.N. Týp Fakültesi, Göðüs Hastalýklarý AD, Latur, Maharaþtra, Hindistan

Tüberküloz menenjit, pediatrik ve geriatrik olgularda en sýk görülen santral sinir sistemi enfeksiyonudur. Pediatrik olgular, basil yayan eriþkin tüberküloz hastalarý ile yakýn temas sonucu hasta olduklarý için aktif eriþkin tüberküloz olgularýnýn taný ve tedavilerinin yapýlmasý ile çocuklarýn bu hastalýktan korunmasý mümkün olabilir. Çocukluk çaðýnda yapýlan BCG aþýlanmasý ile akciðer dýþý ve yaygýn tüberkülozdan çocuklarýn korunduklarýna dair anlamlý veri-ler bulunmasýna raðmen, halen aþýlama rutin olarak yapýlmamaktadýr. Bu olgu sunumunda, geliþme geriliði ve konstitüsyonel semptomlarý olan ve yaygýn akciðer dýþý tüberkülozun menenjit formunda ortaya çýktýðý, iki yaþýndaki çocuk sunulmuþtur. Çocuðun tüberküloz yakýn temasý olarak annesinin yayma pozitif akciðer tüberkülozu olduðu ve antitü-berküloz tedavi aldýðý belirlenmiþtir. Sonuç olarak, Hindistan’da, tüm yeni doðanlara BCG aþýsý yapýlmasýný ve yayma pozitif akciðer tüberkülozlu eriþkinlerin temaslýlarýnýn tüberkülin testinin yapýlarak isoniyazid proflaksisine alýnmasýný tavsiye ediyoruz.

Anahtar Kelimeler: tüberküloz menenjit, BCG aþýsý, isoniyazid, tüberkülin deri testi, anneden çocuða bulaþma

---

CITE