49 YEARS OLD MAN WITH TUBERCULOUS MENINGITIS

Wida Ratnanurmala

Abstract


Tuberculous meningitis is an inflammation reaction of the lining of the brain caused by the germs of tuberculosis and is the most severe form of Mycobacterium tuberculosis infection that can cause death or severe neurological deficits. Tuberculous meningitis is preceded by prodromal symptoms include headache, anorexia, nausea/vomiting, fever, accompanied by changes in behavior, and loss of consciousness. Man, 49 years old, came with loss of consciousness. It has been started since 3 months before admission, the patient has a cough up mucus, fever, weight loss, headache, incoherent speech to a loss of consciousness. On physical examination, the patient had a GCS of 5, stupor, febrile, ronchi on both lungs, and positive meningeal sign. On laboratory results found
leukocytosis, thrombocytosis, X-ray interpretation was miliary tb, cranial CT scan found infarction. The management included general condition improvement, IVFD RL:NaCl 20 drops per minute, 2x50 mg ranitidine ampoule, 3x500 mg paracetamol, 3x500 mg tranexamic acid ampoule, 3x15 ml antacid syrup, 3x5 mg ampoule dexamethason, 1x450 mg rifampisin, 1x300 mg isoniazid, 3x250 mg pyrazinamide, 3x250 mg ethambutol, 1x750 mg streptomycin, 2x1 tablet B6 and B1. Besides the airway, breathing, and circulation management, anti-tuberculosis drugs treatment is required for 12 months. The prognosis is determined by the quick of treatment and the disease stage. [J Agromed Unila 2014; 1(3):249-252]
Keywords: loss of conscioucness, tuberculous meningitis

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