|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 1 | Page : 51
An unusual/varied presentation of two cases of tuberculous meningitis
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
|Date of Submission||22-Mar-2020|
|Date of Decision||20-May-2020|
|Date of Acceptance||31-May-2020|
|Date of Web Publication||30-Jun-2020|
Prof. Mahmood Dhahir Al-Mendalawi
P. O. Box 55302, Baghdad Post Office, Baghdad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Mendalawi MD. An unusual/varied presentation of two cases of tuberculous meningitis. J Integr Health Sci 2020;8:51
|How to cite this URL:|
Al-Mendalawi MD. An unusual/varied presentation of two cases of tuberculous meningitis. J Integr Health Sci [serial online] 2020 [cited 2020 Sep 30];8:51. Available from: http://www.jihs.in/text.asp?2020/8/1/51/288692
In July–December 2019 issue of the Journal of Integrated Health Sciences, Shah et al. nicely described atypical presentation of tuberculous meningitis (TBM) in two Indian patients. It is explicit that the advent of human immunodeficiency virus (HIV) has greatly contributed to the increase in the number of patients with tuberculosis (TB). The clinical picture of TB/HIV co-infection depends on the integrity of immune status. Truly, HIV-associated TB has an atypical clinical, radiological, and biological presentation as well as more frequent extrapulmonary dissemination. The severity tends to be more when there is a significant immune deficiency., In India, HIV infection is a worrying health problem. The available published data showed that the national adult seroprevalence of HIV was estimated at 0.22% (0.16%–0.30%) in 2017. Additionally, the prevalence of HIV/TB co-infection among Indian patients with HIV has been estimated to be significant (12.3%), and 56% of TB lesions in such patients were noticed to be extrapulmonary. It has been suggested that all TB patients in India must be assessed for HIV risk factors and counseled to undergo HIV testing while all HIV-positive patients must be screened for TB. I assume that HIV infection ought to be critically considered in the two cases in question. Regrettably, Shah et al. did not consider HIV infection as the diagnostic set employed in the studied two patients did not recruit HIV testing. Therefore, the diagnostic set for HIV detection in terms of CD4 lymphocyte count and viral overload measurements would have envisaged. If that set was to show HIV reactivity, the two cases in question could be surely regarded novel case reports of atypical presentation of TBM.
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Conflicts of interest
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| References|| |
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