NEUROMENINGEAL TUBERCULOSIS IN INFANTS: A SEVERE PRESENTATION COMPLICATED BY DIFFUSE CEREBRAL ISCHEMIA. A CASE REPORT

Neuromeningeal tuberculosis is a serious complication, particularly in children. We report the case of a 7-month-old Moroccan infant admitted for severe febrile encephalopathy, beginning with high fever, irritability and refusal to eat, rapidly progressing to neurological deterioration. Biological workup revealed hyperleukocytosis, elevated CRP and procalcitonin, and cerebrospinal fluid analysis showed hyperproteinorachia, hypoglycorachia and pleiocytosis, without bacterial isolation. The diagnosis of tuberculosis was confirmed by Xpert® MTB/RIF Ultra on a bronchial swab. Cerebral imaging revealed diffuse ischemic lesions and cerebral involvement, indicating severe vascular complications. Despite intensive intensive care, including anti-tuberculosis treatment and external ventricular bypass, the outcome was fatal. This case highlights the urgent need for early diagnosis and multidisciplinary management.