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Case Reports
. 2018 Oct-Dec;9(4):613-615.
doi: 10.4103/jnrp.jnrp_59_18.

A Young Patient with Stroke and Primary Tuberculosis

Narenraj Arulprakash  1 , Lavanya Narayanan  1 , Senthil Narayanan  1
Affiliations
Case Reports

A Young Patient with Stroke and Primary Tuberculosis

Narenraj Arulprakash et al. J Neurosci Rural Pract. 2018 Oct-Dec.

Abstract

A 21-year-old woman presented with left hemiparesis, fever, dyspnea, tachycardia, and pericardial rub on examination. She was provisionally diagnosed with infective endocarditis and received the final diagnosis of the primary pulmonary tuberculosis (PTB) and extra PTB (EPTB) with pericardial effusion and thoracic lymphadenitis. Left hemiparesis due to a pontine infarct was attributed to TB with neurovasculitis. The diagnosis was supported by findings on imaging studies such as echocardiography, computed tomography of the thorax, and magnetic resonance imaging of the brain. She improved with anti-TB treatment. It is interesting to note that she was not immunodeficient, with the usual suspects such as acquired immunodeficiency syndrome, diabetes mellitus, and renal failure ruled out. We conclude that PTB and EPTB must be considered in any febrile illness, even in patients who are not immunodeficient, considering its atypical presentation and prevalence in India.

Keywords: Extrapulmonary tuberculosis; neurovasculitis; pericardial effusion; pulmonary tuberculosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Ultrasound: moderate Pericardial Effusion. Arrow shows echo-free signal from pericardial fluid. Fibrin strains are also seen within the fluid
Figure 2
Figure 2
Computed Tomography: coronal view of the thorax; Calcified lymph node. Noncontrast coronal computed tomography scan shows hyperattenuation of paratracheal lymph nodes
Figure 3
Figure 3
Computed tomography: axial view of the thorax; mild pericardial effusion. Noncontrast axial computed tomography scan shows diffuse pericardial thickening and mild pericardial effusion
See this image and copyright information in PMC

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