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Abstract Ref Number = APCP1099
Poster Presentation
RARE CASE ACID-FAST BACILLI IN CEREBROSPINAL FLUID SMEAR IN CHILDREN WITH TUBERCULOUS MENINGITIS
Nicholas Redly,Rafiqa Rais Akbar,Eka Widriani Suradji
RSUD Teluk Bintuni
Background : Tuberculous meningitis is the most common complication of tuberculosis in RSUD Teluk Bintuni especially in children. Early finding and treatment of early-stage TB meningitis provides a better outcome, but limited diagnostic resources and low community knowledge of this disease often inhibits the discovery of the case.
Case Presentation Summary : Patient come to emergency room with chief complaint weakness due to decrease of patient’s appetite for one week. Patient had a head trauma before. This illness is accompanied with fever for about one month. The patient was apathetic with positive meningeal sign and pathologic reflex (babinsky, chaddok, and schaffner). TB score count is four (Fever, lymph node enlargement, poor nutritional status, chest X-ray, without Mantoux test). The patient was diagnosed for suspect tuberculous meningitis. The results of cerebrospinal fluid analysis showed acid-fast bacilli. CT scan of the head show obstructive hydrocephalus due to tuberculoma. Patient had general tonic seizure twice at the hospital and then patient consciousness decrease. Patients are treated with tuberculosis drug regiment, antibiotics, and steroids. The patient's awareness was improving.
Learning Points/Discussion : Despite the chief complaint not leading to tuberculosis meningitis, Acid-fast bacilli found in cerebrospinal smear or culture is a gold standard to diagnose tuberculosis meningitis.
Keywords: Tuberculous meningitis Acid-fast bacilli Tuberculosis
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