Abstract
OBJECTIVE: To report the case of a pediatric patient diagnosed with neurotuberculosis, a rare manifestation of the disease, relating it to the literature. CASE REPORT: Male patient, 10 months old, started with chronic cough associated with fever, lymphadenopathy, in addition to right hemibody paresis and episodes of convulsive crises. In the anamnesis, there was evidence of home contact with a patient with pulmonary tuberculosis who had not been adequately treated. Tuberculin test was performed, with negative result. Cerebrospinal fluid analysis showed negative rapid test for tuberculosis, hypoglycorrhachia, increased proteins and cellularity at the expense of lymphocytes and negative bacterioscopy. The association of computed tomography and magnetic resonance imaging findings with clinical data, then, indicated the possibility of neurotuberculosis with complicated vasculitis and cerebral infarction. Diagnostic confirmation was only possible after a week of hospitalization, with the positive result of the rapid molecular test for Mycobacterium tuberculosis in a sample of gastric lavage. It was decided, then, to start the scheme rifampicin 15 mg/Kg, isoniazid 10 mg/Kg, pyrazinamide 35 mg/Kg and dexamethasone 0.3 mg/Kg. After 20 days, the patient was in good general condition and was discharged for outpatient follow-up. CONCLUSION: Neurotuberculosis is a rare and challenging clinical presentation in the pediatrics practice. The fast diagnosis and the early treatment impact directly in the child morbimortality. Therefore, it must be considered as a differential diagnosis in various neurological presentations.