Tuberculoma, presenting with features of meningism
is not very common.
Two cases had recorded fever, three had focal signs, three had confusion, three had meningism
, three had convulsions and one had a recorded history of dehydration that poses a risk for dural venous sinus thrombosis.
Patients with extrapulmonary or disseminated TB may present with signs and symptoms specific to the involved site, such as lymphadenopathy, headache, meningism
, dysuria, back pain, ascites or abdominal pain.
, commonly associated with the meningeal irritation of meningitis, may be mistaken for neck stiffness associated with impending tonsillar herniation.
Other common symptoms were headache (24 patients), altered consciousness (10 patients), meningism
(8 patients), hemiparesis (7), ataxia (7), dizziness (6), and seizures (4).
Headache with fever can indicate meningism
, a condition in which the person is unable to move the neck forward.
There was no meningism
or clear focal neurological deficit, so lumbar puncture was not performed.
Dutta et al mentioned in their report that triad of fever, meningism
and leukocytosis, as seen in our patient, may be suggestive for PA.
A minority of victims go on to meningism
, headache and fever then weakness in one or more muscle groups, which may progress to widespread paresis, respiratory failure and death.
Systemic Family history features Fever/night sweats, weight loss, arthropathy, rash, ulcers, dry mouth and eyes, ocular disease Neurological Persistent headache, fits, features encephalopathy, meningism
, movement disorders, stroke-like events, peripheral neuropathy Investigations Raised ESR and/or CRP, serology; abnormal CXR Absent oligoclonal bands or persistent CSF pleocytosis Normal MRI or pronounced meningeal enhancement Table 2.
The examination at the time of admission showed a drowsy patient, no meningism
, pupils equal and reactive to light and accommodation, intact corneal and gag reflexes and no dysphagia present.
There were no signs of meningism
and the cranial nerves were all functional.
But the sheriff said Gray had effectively sought to exclude meningism
when that could only have been done by a hospital.
They describe topics of common concern, such as meningitis and meningism
, gastrointestinal infection, community-acquired pneumonia, rash in pregnancy and in children, illness in returning travelers, sexually-transmitted infections, jaundice, infection in those whose immune systems are compromised, and queries about vaccines.
Meningococcal disease is typically diagnosed in children at presentation to a hospital after the onset of late-occurring classic symptoms, which include hemorrhagic rash, meningism
, and impaired consciousness.