Operated case of tubercular meningitis with hydrocephalus in an immunocompromised patient and acute abdomen-management controversy: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20213680Keywords:
Tubercular meningitis, Intestinal tuberculosis, Ventriculo-Peritoneal shuntingAbstract
Tuberculosis is a very common infectious disease in developing countries like India. Most common form includes pulmonary tuberculosis. Other common forms are tubercular meningitis and intestinal tuberculosis. Hydrocephalus is one of the commonest complications of tubercular meningitis. We present a HIV positive case who had tubercular meningitis with hydrocephalus and was operated for ventriculoperitoneal shunting, later developed intestinal tuberculosis with perforation peritonitis. The presentation of an acute abdomen with a ventriculo-peritoneal shunt requires skillful diagnostic workup and management. Apart from complications caused by the shunt, primary abdominal pathological conditions must be taken into consideration. Tuberculosis has multiple presentations all of which should be kept in mind.
References
Chadha VK. Tuberculosis epidemiology in India: a review. Int J Tuberc Lung Dis. 2005;9(10):1072-82.
Chakraborty AK. Epidemiology of tuberculosis: current status in India. Indian J Med Res. 2004;120(4):248-76.
Williams BG, Granich R, Chauhan LS, Dharmshaktu NS, Dye C. The impact of HIV/AIDS on the control of tuberculosis in India. Proc Natl Acad Sci USA. 2005;102(27):9619-24.
Rizvi I, Garg RK, Malhotra HS, Kumar N, Sharma E, Srivastava C et al. Ventriculo-peritoneal shunt surgery for tuberculous meningitis: A systematic review. J Neurol Sci. 2017;375:255-63.
Rajshekhar V. Management of hydrocephalus in patients with tuberculous meningitis. Indian Perspective. 2009;57(4):368-74.
Peng J, Deng X, He F, Omran A, Zhang C, Yin F, Liu J. Role of ventriculoperitoneal shunt surgery in grade IV tubercular meningitis with hydrocephalus. Childs Nerv Syst. 2012;28(2):209-15.
Sharma RN, Pruthi N, Arimappamagan A, Somanna S, Devi BI, Pandey P. Tubercular meningitis with hydrocephalus with HIV co-infection: role of cerebrospinal fluid diversion procedures. J Neurosurg. 2015;122(5):1087-95.
Pumberger W, Löbl M, Geissler W. Appendicitis n children with Ventriculoperitoneal Shunt. Pediatr Neurosurg. 1998;28:21-6.