TY - DATA T1 - A fatal case of tuberculous meningitis in a child with juvenile idiopathic arthritis: a diagnostic challenge PY - 2017/12/05 AU - Zumrut Sahbudak Bal AU - Pinar Yazici AU - Semra Sen AU - Cenk Eraslan AU - Cengiz Cavusoglu AU - Bulent Karapinar AU - Fadil Vardar UR - https://scielo.figshare.com/articles/dataset/A_fatal_case_of_tuberculous_meningitis_in_a_child_with_juvenile_idiopathic_arthritis_a_diagnostic_challenge/5667277 DO - 10.6084/m9.figshare.5667277.v1 L4 - https://ndownloader.figshare.com/files/9895462 L4 - https://ndownloader.figshare.com/files/9895465 L4 - https://ndownloader.figshare.com/files/9895468 KW - Tuberculosis KW - Tumor necrosis factor antagonist KW - Juvenile idiopathic arthritis N2 - Abstract The prognosis of tuberculous meningitis, a rare form of extrapulmonary tuberculosis, depends on the stage of treatment initiation. We report a fatal case of tuberculous meningitis. The patient had received successive tumor necrosis factor (TNF) antagonists and abatacept to treat juvenile idiopathic arthritis, with negative results for polymerase chain reaction and acid-fast bacilli on smear, had normal cerebrospinal fluid (CSF) adenosine deaminase and glucose levels. Six weeks post-admission, the CSF culture demonstrated Mycobacterium tuberculosis. The altered immunological responses caused by anti-TNF treatment made the diagnosis challenging. Clinicians should bear this in mind and, if suspected, treatment should be initiated immediately. ER -