Tuberculosis Related Ischemic Stroke : A Case Report

Authors

  • Rizaldy Taslim Pinzon Neurology Department, Duta Wacana Christian University School of Medicine, Yogyakarta, Indonesia
  • Veren Amoreta Vidyatama Department of Medicine, Faculty of Medicine, Duta Wacana Christian University. Jl. Dr. Wahidin Sudirohusodo No.5 - 25, Kotabaru, Gondokusuman, Yogyakarta City, Special Region of Yogyakarta 55224

DOI:

https://doi.org/10.33533/jpm.v17i1.5773

Keywords:

Active TB, Ischemic stroke, Vasculitis

Abstract

Tuberculosis (TB) is a widespread infectious disease caused by Mycobacterium Tubercle Bacilli. In 15-20 % cases of active pulmonary TB, infection spreads to extrapulmonary foci, including the nervous system complications. Ischemic stroke related tuberculosis without meningitis is rare. We report a 74-year-old female presented with rapid onset confusion, unconsciousness, and left hemiparesis. She had been recently diagnosed with active TB 3 months ago and treated with combination anti tuberculosis regiment. Her recent acute neurological manifestations began within 24 hours prior to admission in the hospital. The brain CT showed  middle cerebral artery territory infarction. The risk factors tracing found no significant abnormality. The only abnormal finding was high CRP. This report describes rare case of a patient with active TB and who presented with acute ischemic stroke.

References

Lammie GA, Hewlett RH, Schoeman JF, Donald PR. Tuberculous cerebrovascular disease: a review. J Infect. 2009;59:156–66. https://doi.org/10.1016/j.jinf.2009.07.012

Maheswari EU, Bhoopathy RM, Bhanu K, & Anandan, H. Clinical Spectrum of Central Nervous System Tuberculosis and the Efficacy of Revised National Tuberculosis Control Program in its Management. Journal of neurosciences in rural practice. 2019;10(1):71–77. https://doi.org/10.4103/jnrp.jnrp_163_18

Wu C-H, Chen L-S, Yen M-F, Chiu Y-H, Fann C-Y, Chen H-H, et al. (2014) Does Non-Central Nervous System Tuberculosis Increase the Risk of Ischemic Stroke? A Population-Based Propensity Score-Matched Follow-Up Study. PLoS ONE 9(7): e98158. https://doi.org/10.1371/journal.pone.0098158

Sheu JJ, Hsu CY, Yuan RY, Yang CC. Clinical characteristics and treatment delay of cerebral infarction in tuberculous meningitis. Intern Med J. 2012;42:294–300. https://doi.org/10.1111/j.1445-5994.2010.02256.x

Huaman MA, Henson D, Ticona E, Sterling TR, Garvy BA. Tuberculosis and cardiovascular disease: linking the epidemics. Trop Dis Travel Med Vaccin 2015;1:. https://doi.org/10.1186/s40794-015-0014-5

B. Zalba Etayo, B. Obó n Azuara, I. Gutié rrez Co., B. Villanueva Duckling, R. Ridruejo Sá ez Infarction of Middle Cerebral Artery as a Presentation of Miliary Tuberculosis. An. Med. Interna (Madrid) 25: 4,2008.https://www.researchgate.net/publication/5247347_Middle_cerebral_artery_ischemic_stroke_presentation_of_miliar_tuberculosis

Abbas SW, Rodriguez Jreynolds C, Minagar A, Gonzalez-Toledo E. Miliary tuberculosis manifesting as acute ischemic stroke and hypothermia in a patient with multiple brain tuberculomas. Open J Clin Med Case Rep. 2016; 1111. http://jclinmedcasereports.com/articles/OJCMCR-1111.pdf

Briones-Claudett KH, Briones-Claudett MH, Briones Zamora KH, Nieves Velez RD, Martinez Alvarez ME, Grunauer Andrade M. Ischemic Stroke and Disseminated Tuberculosis in Intensive Care: A Case Report. Am J Case Rep. 2020 Jun 5;21:e920410. https://doi.org/10.12659/AJCR.920410

Sy MCC, Espiritu AI, Pascual JLR. Global Frequency and Clinical Features of Stroke in Patients With Tuberculous Meningitis: A Systematic Review. JAMA Netw Open. 2022;5(9):e2229282. https://doi.org/10.1001/jamanetworkopen.2022.29282

Lindsberg PJ, Grau AJ. Inflammation and infections as risk factors for ischemic stroke. Stroke. 2003; 34: 2518–2532. https://doi.org/10.1161/01.STR.0000089015.51603.CC

A.J. Grau, C. Urbanek, F. Palm Common infections and the risk of stroke Nature Rev Neurol, 6 (12) (2010), pp. 681-694. https://doi.org/10.1038/nrneurol.2010.163

A.D. Salindri, J.-Y. Wang, H.-H. Lin, M.J. Magee Post-tuberculosis incidence of diabetes, myocardial infarction, and stroke: retrospective cohort analysis of patients formerly treated for tuberculosis in Taiwan, 2002–2013 Int J Infect Dise, 84 (2019), pp. 127-130. https://doi.org/10.1016/j.ijid.2019.05.015

Downloads

Published

2023-06-14

How to Cite

Pinzon, R. T., & Vidyatama, V. A. (2023). Tuberculosis Related Ischemic Stroke : A Case Report. Jurnal Profesi Medika : Jurnal Kedokteran Dan Kesehatan, 17(1). https://doi.org/10.33533/jpm.v17i1.5773

Issue

Vol. 17 No. 1 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan

Section

Case Study

Categories

License

Copyright (c) 2023 Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright Notice

All articles submitted by the author and published in the Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan, are fully copyrighted by the publication of Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan under the Creative Commons Attribution-NonCommercial 4.0 International License by technically filling out the copyright transfer agreement and sending it to the publisher

Note :

The author can include in separate contractual arrangements for the non-exclusive distribution of rich versions of journal publications (for example: posting them to an institutional repository or publishing them in a book), with the acknowledgment of their initial publication in this journal.

Authors are permitted and encouraged to post their work online (for example: in an institutional repository or on their website) before and during the submission process because it can lead to productive exchanges, as well as earlier and more powerful citations of published works. (See Open Access Effects).