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Bacteriologically Confirmed neuromeningeal tuberculosis at the Hubert Koutoukou Maga National Hospital and University Center in Cotonou: About Two Cases Study and a Review of the Literature

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Open Journal of Internal Medicine 2020年第2期10卷 190-197页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Leoubou Roger Samuel Dodo Mahoutin Semassa Ghislain Missiho Roberto Dossou Torès Kouassi Prudencio Delphin Murhula Marius Doukpo Eugénie Dansou Thomas Lokossou Djimon Marcel Zannou Fabien Fabien Internal Medicine Department of CNHU-HKM Cotonou Benin Multi-Purpose Anesthesia and Resuscitation Department of CNHU-HKM Cotonou Benin

Introduction: tuberculosis remains a major public health problem. The damage to the central nervous system is severe. We reported here two cases. Clinical Case 1: A 37-year-old female patient, naively Human Immunodeficiency Virus1 (HIV1)-positive with antiretroviral (ARV) treatment, hospitalized in the Internal Medicine department for altered consciousness in a febrile context. The clinical examination at admission noted a meningeal syndrome. Cytological analysis of the cerebrospinal fluid (CSF) revealed lymphocytic meningitis with 98% lymphocytes for 3634 leukocytes. CSF polymerase chain reaction (PCR) detected Mycobacterium tuberculosis DNA. She was put on anti-tuberculosis treatment. The immediate course was favourable, but a secondary worsening of the clinical picture was the cause of his death. Clinical Case 2: A 34-year-old male patient, naively HIV1-positive with ARV treatment. He is hospitalized in the Multi-Purpose Anaesthesia and Resuscitation Department of the CNHU HKM for altered consciousness in a feverish context. The clinical examination noted a meningeal syndrome. The cytological analysis of the CSF noted 184 leukocytes for 99% lymphocytes. The CSF PCR identified the DNA of Mycobacterium tuberculosis. He was put on anti-tuberculosis treatment. The evolution was marked by his death. Conclusion: The neuromeningeal localization of tuberculosis is a poor prognosis. Co-infection with HIV remains a potential deadly combination.

关键词： neuromeningeal tuberculosis HIV Infection Death Cotonou

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