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Case Reports
. 2020 Sep 14;13(9):e238597.
doi: 10.1136/bcr-2020-238597.

Child with tuberculous meningitis and COVID-19 coinfection complicated by extensive cerebral sinus venous thrombosis

Farida Essajee  1 , Regan Solomons  1 , Pierre Goussard  2 , Ronald Van Toorn  1
Affiliations
Case Reports

Child with tuberculous meningitis and COVID-19 coinfection complicated by extensive cerebral sinus venous thrombosis

Farida Essajee et al. BMJ Case Rep. .

Abstract

We herein report a case of a child with tuberculous meningitis and COVID-19 coinfection complicated by hydrocephalus, arterial ischaemic stroke and extensive cerebral sinus venous thrombosis. Both conditions induce a proinflammatory cytokine drive resulting, among others, in a prothrombotic state. The disruption of the coagulation system in this case was supported by elevated D-dimers, fibrinogen and ferritin levels, consistent with thrombotic complications reported in some adult patients infected with COVID-19. The child also exhibited prolonged viral shedding that suggests severe disease.

Keywords: global health; infections; neurology (drugs and medicines); paediatrics (drugs and medicines); radiology (diagnostics).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Chest radiograph demonstrated a reticulonodular pattern in keeping with miliary tuberculosis. A right-sided ventriculo-peritoneal shunt is visible.
Figure 2
Figure 2
Axial contrasted CT showing infarction involving the right internal capsule extending to the lentiform nucleus (see arrow).
Figure 3
Figure 3
(A and B) Sagittal contrasted CT showing a filling defect in the superior sagittal sinus (see arrow). (B) Sagittal contrasted CT showing a filling defect in the right transverse sinus (see arrow).
See this image and copyright information in PMC

References

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