PREFACE

First and foremost, we would like to express our gratitude to our

supervisor for this case report, dr. H. Ridwan M Daulay, Sp.A(K) for the
encouragement and the teachings that are handed down to us during the process of
making this case report.
This paper will also not be completed if it wasnt for the help of residents
in Pediatric Department, especially those in the infection unit and in the neurology
division. We would also like to thank our family and friends for their support.
The objective of this case report is to report a case of tuberculous
meningitis in 9 month old girl, who is a patient form the infection unit Pediatric
Department of Haji Adam Malik General Hospital. It is also serve its purpose as a
learning tool in Pediatric Department of Internship Program, Faculty of Medicine,
Universitas Sumatera Utara.
What is collected in this case report are materials that we found in articles
and books, thus we make no claim to be comprehensive. To readers, we humbly
apologize if the case report is not perfect but yet we had tried our best in
delivering the case report. With that, we hope that this will be beneficial to all.

Medan, June 6th 2012

Writers

CONTENTS
PREFACE.................................................................................................................
...................................................................................................................................i
CONTENTS..............................................................................................................
..................................................................................................................................ii
CHAPTER 1 INTRODUCTION
1.1.Background...................................
1
1.2.Objective...
2
CHAPTER 2 LITERATURE REVIEW
2.1. Definition.....................................................................................................
3
2.2. Etiology........................................................................................................
3
2.3. Risk Factor...................................................................................................
4
2.4. Pathogenesis.................................................................................................
5
2.5. Pathophysiology...........................................................................................
6
2.6. Diagnosis......................................................................................................
...................................................................................................................8
..................................................................
2.6.1. Clinical Presentation
.....................................................................................................................
...................................................................................................................8
2.6.1. Clinical Presentation.........................................................................
...................................................................................................................8
2.6.2. Lumbar Puncture...............................................................................
.................................................................................................................10

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2.6.3. Latex Agglutination Test...................................................................

.................................................................................................................12
2.6.4. PCR...................................................................................................
.................................................................................................................14
2.6.5. sTREM-1...........................................................................................
.................................................................................................................14
2.6.6. Blood Culture....................................................................................
.................................................................................................................14
2.7. Differential Diagnoses.................................................................................
................................................................................................................14
2.8. Management.................................................................................................
15
2.9. Complication................................................................................................
18
2.10 Prognosis.....................................................................................................
19
CHAPTER 3 MEDICAL RECORD
3.1. Case...............................................................................................................
................................................................................................................................20
....................................................................................................................................
3.2. Discussion.....................................................................................................
................................................................................................................................38
....................................................................................................................................
3.3. Summary.......................................................................................................
................................................................................................................................40
....................................................................................................................................
REFERENCES

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