Maladies neuroinfectieuses

Abstrait

Rifampicin-Resistance Tuberculous Meningitis in a Patient with Cerebral Lupus Diagnosed Using Cerebrospinal Xpert Mtb/Rif Test

Mohamed Faisal Abdul Hamid, Soo Chun Ian, Andrea Ban Yu-Lin, Mohd Shahrir Mohamed Said and Roslina Abdul Manap

Tuberculous (TB) meningitis or tubercular meningitis is a Mycobacterium tuberculosis infection of the meninges—the system of membranes which envelop the central nervous system. Molecular tests like the automated rapid molecular assay Xpert® MTB/RIF greatly expedites the detection of M. tuberculosis complex and rifampicin resistance. We report a 22-year old man with cerebral lupus and concurrent rifampicin resistance tuberculous meningitis which was detected by Xpert® MTB/RIF test in the cerebrospinal fluid. The rifampicin resistance in this patient was due to poor compliance. The patient took one tablet of akurit-4 throughout the intensive phase of treatment. This report highlights the usefulness of molecular testing which allowed a faster diagnosis than a bacteriologic confirmation of drug resistant tuberculosis. This is important as early diagnosis and treatment leads to better outcome in TBM.