Tuberculosis – two unusual types of presentation

Abstract

The World Health Organization declared tuberculosis as a medical
global emergency in 1993. In fact, in the past decades it has
assumed a crescent importance as a public health problem. The
authors report two clinical cases with a typical presentation. The
first one refers to a 32 year old woman, with no prior medical
history, who went to the Emergency Department because of a
sudden reduction of visual acuity at left. A left cervical mass was
also detected. After the clinical examination and the adequate
study, it was diagnosed left papilledema and lymph node tuberculosis. She was medicated with steroid and antibacillar therapy.
The second one refers to a 41 year old woman, who was admitted
to the Infectious Diseases Department with the diagnosis of
presumable bacterial meningitis. There was a significant clinical
worsening. The second examination of the liquor allowed the
tuberculous meningitis diagnosis. She started antibacillar therapy.
As intercurrences, she had a stroke and a low respiratory tract
infection with respiratory insufficiency and need of invasive ventilator support. After clinical stabilization concerning to respiratory
distress, she went back to the Infectious Diseases Department, where she died.
The authors pretend to stress out that tuberculosis is assuming
an important role nowadays, sometimes with less typical presentations and in patients with preserved immunity system.