结核性脑膜脑炎合并COVID-19死亡1例

B. Munir, B. A. Pradana, W. M. Santoso, Ria Damayanti, C. Setianto, Samiah Rachmawati
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引用次数: 0

摘要

结核性脑膜脑炎(TBM)是最严重的、危及生命的结核病,占肺外结核病例的5%。2019年底出现的COVID-19已被证明会影响包括大脑在内的各种器官。在本病例报告中,一名21岁的女性被诊断为TBM,正处于结核治疗的强化阶段,入院前一天出现吞咽困难和发音困难,并伴有脑膜阳性征象,复视和头痛症,在先前好转后加重。入院前两天出现咳嗽和发烧。实验室结果显示,PCR阳性,CT扫描显示,与一个月前的CT扫描相比,脑膜轻脑膜增强。患者静脉注射地塞米松、抗结核药物、苯妥英、阿司匹林、奥司他韦和羟氯喹。该患者因呼吸衰竭住院4天后死亡。本病例报告显示,COVID-19和结核分枝杆菌合并感染导致结核病治疗反应和结果不佳。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19
: Tuberculous meningoencephalitis (TBM) is the most severe, life-threatening form of tuberculosis that contributes to as much as 5% of cases of extrapulmonary tuberculosis. Emerging at the end of 2019, COVID-19 has been shown to affect various organs, including the brain. In this case report, a 21-year-old woman diagnosed with TBM, being in the intensive phase of tuberculous therapy, came with dysphagia and dysphonia as new complaints felt one day before admission accompanied by a positive meningeal sign, diplopia, and cephalgia, which became heavier after previously getting better. Cough and fever followed this complaint two days before admission. About the laboratory results, the PCR was positive for COVID-19, and CT scans showed increased leptomeningeal enhancement when compared with CT scan one month earlier. The patient received intravenous dexamethasone, anti-tuberculosis drugs, phenytoin, aspirin, oseltamivir, and hydroxychloroquine. The patient died four days after being hospitalized due to respiratory failure. This case report shows the coinfection of COVID-19 and TBM resulting in a poor tuberculosis treatment response and outcome.
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