Tuberculous Meningitis: a case report of a late diagnosis

Abstract

Introduction: Tuberculous meningitis (TM) is the most severe form of tuberculosis, it has high morbidity and mortality. Once it is diagnosed early, treatment response is excellent. Objective: To report and discuss a case of delayed diagnosis of TM. Methodology: It was selected a case from University Hospital of Federal University of Santa Catarina, the analysis of medical records was performed and discussed based on the scientific literature. Results: It was reported the case of a patient that was diagnosed with leukocytoclasticvasculitis (LV) for six months and was admitted presenting granulomatous lung injury, weight loss, fever and dry cough for eigth months. The delay in the diagnosis of tuberculosis (TB) allowed an evolution to TM and the late onset of treatment impaired the patient’s prognosis. It was discussed the vasculitis as a first symptom of tuberculosis, which can occur by deposition of immune complexesformed by antibodies against antigens of bacilli in the vascular wall. Conclusions: Previous diagnosis of LV deviated the focus of the case for their cause, and suggested other pathologic conditions, which contributed to delay in the diagnosis of TB. Despite the late diagnosis and treatment, the therapeutic approaches used for vasculitis, TB and TM followed the protocols described in the literature.