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. 2015 Dec;64(5):543-547.
doi: 10.7727/wimj.2016.055. Epub 2016 Apr 29.

Paroxysmal Sympathetic Hyperactivity in a Child with Tuberculous Meningitis A Case Study and Review of Related Literature

Y Xu  1 , L Wan  2 , J Ning  2 , W Guo  2 , L Ren  2
Affiliations

Paroxysmal Sympathetic Hyperactivity in a Child with Tuberculous Meningitis A Case Study and Review of Related Literature

Y Xu et al. West Indian Med J. 2015 Dec.

Abstract
in English, Spanish

A one-year old boy was admitted to hospital for lethargy and vomiting over three days. Neurological examination revealed abnormalities. Cerebrospinal fluid examination showed evidence of meningitis. A purified protein derivative (PPD) test, T-SPOT.TB and radiological examination indicated tuberculous meningitis. During treatment, the child developed hypertension, sinus tachycardia, tachypnoea, dystonia and high fever. These episodes improved after administration of propranolol, artane and clonazepam. Paroxysmal sympathetic hyperactivity is a rare manifestation of tuberculous meningitis. Early detection is very important as it can avoid diagnostic errors and overtreatment.

Un niño de un año de edad fue admitido al hospital de letargia y vómitos durante tres días. La examinación neurológica reveló anormalidades. Examinación del líquido cerebroespinal demostró evidencia de la meningitis. Una prueba de proteína purificada derivado (PPD), T-SPOT.TB y examen radiológico indican meningitis tuberculosa. Durante el tratamiento, el niño desarrolló hipertensión, taquicardia, taquipnea, distonía y fiebre alta. Estos episodios se mejoraron después de la administración de propranolol, artane y clonazepam. Hiperactividad simpática paroxística es una manifestación rara de la meningitis tuberculosa. La detección temprana es muy importante, ya que puede evitar sobretratamiento y errores de diagnóstico.

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