Prolonged Corticosteroid Use in the Treatment of Tuberculous Meningoencephalitis: : A Case Report

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dc.contributor.authorHolstroma, Annija
dc.contributor.authorBalodis, Arturs
dc.contributor.authorBrokāns, Artis
dc.contributor.authorVīksna, Anda
dc.contributor.institutionDepartment of Radiology
dc.contributor.institutionDepartment of Infectology
dc.date.accessioned2025-01-27T12:20:01Z
dc.date.available2025-01-27T12:20:01Z
dc.date.issued2025-02
dc.descriptionPublisher Copyright: © 2025 by the authors.
dc.description.abstractTuberculous meningoencephalitis is a rare manifestation of Mycobacterium tuberculosis (Mtb), with the most severe form and highest mortality. It can cause multiple complications, and treatment is difficult, as drugs cannot properly diffuse through the haemato-encephalitic barrier. We reported the case of a 17-year-old female patient who was admitted to the emergency room department with a fever for previous two weeks (up to 39 °C), dizziness, difficulty walking, and weight loss. Magnetic resonance imaging indicated possible meningoencephalitis, and a CT scan of the lungs visualised miliary infiltrates in both lungs. After repeated tests, Mtb DNA was found in the bronchial wash, cerebrospinal fluid, faeces, and urine via an Xpert/Rif Ultra test. Treatment was started with isoniazid, rifampicin, ethambutol, pyrazinamide, and corticosteroids as well. Although treatment was initiated within the first few days in the hospital, a reduction in glucocorticoid dosage worsened the patient’s neurological state, making treatment even more challenging. Prolonged use of glucocorticoids led to an improvement in the stage of the condition. Further, over time, the patient’s condition improved. Pulmonary infiltrations were not found after 2.5 months of starting therapy. Conclusions: Timely treatment is crucial for improving the prognosis of patients with miliary tuberculosis and tuberculous meningoencephalitis. Prompt recognition of symptoms and accurate diagnosis are essential to initiate effective treatment strategies. In this patient’s case, prolonged use of corticosteroids reduced neurologic complications, and ongoing treatment gradually improved the patient’s condition.en
dc.description.statusPeer reviewed
dc.format.extent10
dc.format.extent4514676
dc.identifier.citationHolstroma, A, Balodis, A, Brokāns, A & Vīksna, A 2025, 'Prolonged Corticosteroid Use in the Treatment of Tuberculous Meningoencephalitis: A Case Report', Medicina (Kaunas), vol. 61, no. 2, 214, pp. 1-10. https://doi.org/10.3390/medicina61020214
dc.identifier.doi10.3390/medicina61020214
dc.identifier.issn1648-9144
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/17041
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85218976664&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofMedicina (Kaunas)
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectcentral nervous system
dc.subjecttuberculous meningoencephalitis
dc.subjecttuberculosis
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectSDG 3 - Good Health and Well-being
dc.titleProlonged Corticosteroid Use in the Treatment of Tuberculous Meningoencephalitis: : A Case Reporten
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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