Document Detail


Tuberculous radiculomyelitis presenting as urinary retention in a child with Down's syndrome.
MedLine Citation:
PMID:  22602831     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tuberculous radiculomyelitis (TBRM) is an uncommon complication of TB meningitis. The authors report the case of a 10-year-old Asian girl with trisomy 21, who presented with acute urinary retention and fever. She was initially treated for a urinary tract infection. After an acute neurological deterioration she was found to have evidence of TB meningitis with TBRM. She developed acute hydrocephalus requiring ventriculo-peritoneal shunt. She was treated with quadruple antituberculous therapy and high dose intravenous dexamethasone. She needed tracheostomy with continuous positive airway pressure (CPAP) support. Although she showed gradual neurological improvement in her cognitive functions, she persisted to have quadriparesis with the need for tracheostomy and CPAP support overnight and gastrostomy feeding. Acute urinary retention in children is uncommon, and should serve as a 'red flag' to consideration of further underlying neurological problems. This presentation and subsequent events should serve as a learning point to clinicians.
Authors:
Arani Sridhar; Jasjit K Bhandari; Gareth Lewis; Subramanian Ganesan; Srinivas Parepalli; Lara Abulhoul
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-04-02
Journal Detail:
Title:  BMJ case reports     Volume:  2012     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-05-18     Completed Date:  2013-02-12     Revised Date:  2014-04-15    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Antitubercular Agents / therapeutic use*
Child
Dexamethasone / therapeutic use
Diagnosis, Differential
Down Syndrome / complications*
Drug Therapy, Combination
Female
Gastrostomy
Glucocorticoids / therapeutic use
Humans
Magnetic Resonance Imaging
Myelitis / diagnosis*,  drug therapy,  microbiology*
Radiculopathy / diagnosis*,  drug therapy,  microbiology*
Tracheostomy
Tuberculosis, Meningeal / complications*,  diagnosis*,  drug therapy
Urinary Retention / etiology*
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 0/Glucocorticoids; 7S5I7G3JQL/Dexamethasone
Comments/Corrections

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