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Case Report | Paediatrics | Volume 15 Issue 5, May 2026 | Pages: 1853 - 1855 | India
Stage 2 Tuberculous Meningitis Mimicking Acute Disseminated Encephalomyelitis in a Child: A Diagnostic Challenge
Abstract: Background: Tuberculous meningitis (TBM) is one of the most severe forms of childhood tuberculosis, accounting for high morbidity and mortality. Its clinical spectrum often overlaps with other infectious and inflammatory conditions of the central nervous system (CNS), such as acute disseminated encephalomyelitis (ADEM). Rapid and accurate diagnosis is critical for timely initiation of anti-tubercular therapy (ATT). Case Presentation: A 9-year-old girl, born of second-degree consanguineous marriage, presented with acute progressive quadriparesis, cranial nerve palsies, headache, vomiting, fever, and altered sensorium. On admission, she was lethargic with GCS 12/15, right abducens (VI) and facial (VII) nerve palsies, hypotonia, and hyporeflexia. MRI brain revealed ill-defined, non-enhancing signal changes in the brainstem, cerebellum, and periventricular region, suggestive of demyelination. Nerve conduction studies were normal. She received intravenous methylprednisolone with initial improvement in neurological status. However, cerebrospinal fluid (CSF) analysis later tested positive for Mycobacterium tuberculosis using cartridge-based nucleic acid amplification test (CBNAAT). ATT was initiated, leading to marked clinical recovery with normalization of cranial nerve function and motor strength. Conclusion: TBM may mimic ADEM in pediatric patients, particularly in tuberculosis-endemic areas. CBNAAT of CSF is an essential diagnostic tool for early and accurate detection. Prompt recognition and treatment can significantly reduce morbidity.
Keywords: Tuberculous meningitis, acute disseminated encephalomyelitis, CSF CBNAAT, pediatric neurology, case report
How to Cite?: Dr. Meet Maheshwari, Dr. Gobinath S, Dr. Hiral Chaudhari, Dr. Sangita Trivedi, "Stage 2 Tuberculous Meningitis Mimicking Acute Disseminated Encephalomyelitis in a Child: A Diagnostic Challenge", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 1853-1855, https://www.ijsr.net/getabstract.php?paperid=SR26529173626, DOI: https://dx.dx.doi.org/10.21275/SR26529173626