4 yr old boy presents with fever 6days headache 3dayas and vomiting one day. He is irritable. He has difficulty in using his rt leg since one day.
Wt 10 kg, ht 106 cm hc 50 cm
His cbc 14000/mm3
Hb10 gm%
Plt 3lakhs
Sgpt 56 iu
Creatinine. 0.8mg%
Csf shows
100 cell lymph 80%
Protein 130 mg%
Sugar 40 mg%
Rbs 86mg%
Csf gram stain awaited
Cbnaat send
Cxr normal
Mtb culture sent
Bacterial culture send
Viral elisa sent
CT scan infarct lt ic
Diagnosis
TBM
How do you justify your dx?
Symptoms >5days
Focal deficit
Csf lymphocytic pleocytosis
Ct infarct
How to treat TBM?
What is tuberculoma?
Superintendent, ICH.