Abstract

SALAS PEREZ, Marcia Darmelly; RIVERA TORREJON, Oscar Orlando; CHAMBERGO MICHILOT, Diego  and  PAUCAR PONGO, Ubaldo. Infrequent migration of primary extrapulmonary tuberculosis: case report. Rev. Urug. Med. Int. [online]. 2019, vol.4, n.3, pp.35-42.  Epub Dec 01, 2019. ISSN 2393-6797.  https://doi.org/10.26445/04.03.4.

Extrapulmonary tuberculosis accounts for 18% of tuberculosis cases, with the pleura (54%), lymph nodes (11.1%), central nervous system (9%) and osteoarticular system (3.6%) as sites of involvement, among others. Clinical manifestations of tuberculous meningoencephalitis are fever, headache, vomiting, altered consciousness, photophobia, cranial nerve involvement, audiovisual alterations, signs of meningeal irritation and neurological focalization. Ostearticular tuberculosis is the result of hematic, lymphatic dissemination or, exceptionally, by direct inoculation. The clinic is insidious, with pain, inflammation and diminished joint range, and can present abscesses and suppurative cavities. However, there are other symptoms of low frequency of appearance, making the diagnosis difficult. For this reason, an infrequent clinical case of extrapulmonary tuberculosis is described, highlighting the spread of Mycobacterium tuberculosis with focus on the left coxofemoral joint to the meninges and brain, and the inappropriate use of adrenal cortex hormones therapy in a seronegative patient for HIV.

Keywords : tuberculosis; meningoencephalitis; osteoarticular; glucocorticoids; dexamethasone.

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