Tuberculous meningitis presenting with unusual clinical features in Nigerians: Two case reports

摘要: Tuberculous meningitis is common in developing countries and accounts for about 7.8% to 14% of all cases tuberculosis Nigeria. Case 1 was a 17-year-old woman who presented with 3-week history weakness the right upper lower limbs, 6-hour inability speak irrational behaviour. She had no remarkable past medical history. Physical examination revealed pyrexia (temperature 38.2°C) altered level consciousness (Glasgow coma score = 7/15). The signs meningeal irritation were present she anisocoria spastic hemiparesis. Other aspects physical normal. Laboratory investigations showed an elevated erythrocyte sedimentation rate, normal cerebrospinal fluid protein reduced glucose. brain computed tomography scan features keeping obstructive hydrocephalus immediately commenced on antituberculous drugs, intravenous steroids mannitol. made clinical recovery discharged home 6 weeks after admission. 2 40-year-old man 6-week headache fever 2-week alteration consciousness. There neck pain and/or stiffness, nausea or vomiting. He other been placed various antibiotics private hospitals before presentation, improvement. young 4/15) febrile 38.5°C) irritation. stem reflexes impaired he quadriparesis. Further essentially analysis inflammation raised rate. hydrocephalus. drugs but despite this his condition deteriorated died sixth day Late presentation tuberculous not rare Nigerians we report two that late our health care facility. This intended make clinicians aware unusual presentations meningitis.