CLINICAL IMPACT OF TUBERCULOUS MENINGITIS DISEASE: A CASE STUDY IN MAKASSAR REGIONAL HOSPITAL

Abstract

One of the diseases that can be transmitted in the air through the bacteria Mycobacterium tuberculosis (M. tuberculosis) is an understanding of Tuberculosis (TB). The M. tuberculosis bacteria spreads to the human body with the help of droplet nuclei, which are 1 to 5 microns in size. Infectious nuclei droplets can be produced when an individual with pulmonary tuberculosis or larynx coughs. Transmission occurs when the individual inhales the bacteria and then crosses through the nasal passages or mouth, upper respiratory tract, and bronchi to reach the alveoli in the lungs. Tuberculous meningitis (TBM) is a subacute disease, resulting from extra-pulmonary complications of pulmonary tuberculosis and transmitting to the meninges. Symptoms can be found 10 days before diagnosis. Initially the individual will experience a prodrome phase characterized by low-grade fever, malaise, headache, dizziness, vomiting, and personality changes that last for several weeks. Furthermore, the client will experience increasingly severe headaches, cranial neuropathy, stroke, hydrocephalus, changes in mental status, and other complications. The case involved in this research is a man aged 32 years at Wahidin Sudirohusodo Hospital. The initial symptoms of the patient begin to speak incoherently. There was also a history of fever since 5 days before admission and headaches without nausea or vomiting since two weeks before admission. His laboratory results reported an increase in white blood cell count (12,100 / µL) and hyponatremia (129 mmol / L). His cerebrospinal fluid analysis proved that there was a tuberculosis infection (low glucose levels, high protein levels, dominant mononuclear cells). Based on this information and examination, this client was diagnosed as having lost consciousness with a positive meningeal sign and left lateralization due to tuberculosis meningitis. Tuberculous meningitis is an area of ​​extra-pulmonary expansion of pulmonary tuberculosis that spreads to the meninges.