<abstract xmlns="http://www.w3.org/1999/xhtml">Background: Miliary tuberculosis is a haematogenuous dissemination of Mycobacterium Tuberculosis (M. tuberculosis) witch involves especially lungs, central nervous system and lymph node. It is a very severe disease with an increased risk of respiratory failure, extensive neurologic sequelas and high mortality. A rapid diagnosis and specific treatment is tremendous important for outcome. Association of strokeis common in tuberculous meningitis (MTB) and could delay the diagnosis and worse the prognosis.Case presentation: We present a case of 24 years old male, who present asthenia and 20 kilo weight lossduring the last 2 years before admission in hospital. He came in hospital, directly in Intensive CareUnit (ICU) for left hemiplegia followed within hours of fever, repeated focal seizures and coma, reaching a Glasgow score of 6 about 48 hours after admission. Patient requiredorotracheal intubation. The Chest radiograph reveal micro-nodular opacities compatible with miliary TB and the cerebrospinal fluid (CFS) examination led to suspicion of TB meningitis. The Tb etiology was bacteriologically confirmed in sputum and cerebrospinal fluid. After 24 hors, theCT and angio-MRI detected the ischemic lesion in the middle cerebral arterial territory. The injectable antituberculous treatment with 4 drugs was immediately initiated. Parenteral cortichosteroids, anticoagulant, symptomatictreatments were associated. The patient received a very complex and prolonged nursing intervention followed by neurologic and pulmonary rehabilitation in ICU and in the Pneumophtisiology Department. The rehabilitation team identifies the all subjective and objective demands and plan the nursing process of care. When patient gains consciousness the neurologic and pulmonary rehabilitation were started. The evolution was slow, but favorable, after 6 moths of treatment the impairment of left hand movement being the only remaining sign of the past disease.Conclusions: Collaboration medical team consisting of a neurologist, pulmonologist, infection disease specialist and physiotherapist increased the success rate, diminish the sequelas and improve the quality of life of the patient.</abstract>

Background: Miliary tuberculosis is a haematogenuous dissemination of Mycobacterium Tuberculosis (M. tuberculosis) witch involves especially lungs, central nervous system and lymph node. It is a very severe disease with an increased risk of respiratory failure, extensive neurologic sequelas and high mortality. A rapid diagnosis and specific treatment is tremendous important for outcome. Association of strokeis common in tuberculous meningitis (MTB) and could delay the diagnosis and worse the prognosis.Case presentation: We present a case of 24 years old male, who present asthenia and 20 kilo weight lossduring the last 2 years before admission in hospital. He came in hospital, directly in Intensive CareUnit (ICU) for left hemiplegia followed within hours of fever, repeated focal seizures and coma, reaching a Glasgow score of 6 about 48 hours after admission. Patient requiredorotracheal intubation. The Chest radiograph reveal micro-nodular opacities compatible with miliary TB and the cerebrospinal fluid (CFS) examination led to suspicion of TB meningitis. The Tb etiology was bacteriologically confirmed in sputum and cerebrospinal fluid. After 24 hors, theCT and angio-MRI detected the ischemic lesion in the middle cerebral arterial territory. The injectable antituberculous treatment with 4 drugs was immediately initiated. Parenteral cortichosteroids, anticoagulant, symptomatictreatments were associated. The patient received a very complex and prolonged nursing intervention followed by neurologic and pulmonary rehabilitation in ICU and in the Pneumophtisiology Department. The rehabilitation team identifies the all subjective and objective demands and plan the nursing process of care. When patient gains consciousness the neurologic and pulmonary rehabilitation were started. The evolution was slow, but favorable, after 6 moths of treatment the impairment of left hand movement being the only remaining sign of the past disease.Conclusions: Collaboration medical team consisting of a neurologist, pulmonologist, infection disease specialist and physiotherapist increased the success rate, diminish the sequelas and improve the quality of life of the patient.

Nursing’s approach and rehabilitation in a severe case of miliary tuberculosis complicated with stroke.

Faculty of Medicine, “Ovidius” University, Constanta, Romania

Clinical Pneumophtisiology Hospital of Constanta, Romania

Emergency Clinical Hospital of Constanta County

Clinical Infectious Diseases Hospital of Constanta, Romania

ARS Medica Tomitana

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background: Miliary tuberculosis is a haematogenuous dissemination of Mycobacterium Tuberculosis (M. tuberculosis) witch involves especially lungs, central...

Nursing’s approach and rehabilitation in a severe case of miliary tuberculosis complicated with stroke.

Publié en ligne: 11 juin 2016

Pages: 56 - 61

DOI: https://doi.org/10.1515/arsm-2016-0010

Mots clés
miliary tuberculosis, meningitis, stroke, nursing, rehabilitation

© 2016 Dantes Elena et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Nursing’s approach and rehabilitation in a severe case of miliary tuberculosis complicated with stroke.

Publié en ligne: 11 juin 2016

Pages: 56 - 61

DOI: https://doi.org/10.1515/arsm-2016-0010

Mots clésmiliary tuberculosis, meningitis, stroke, nursing, rehabilitation

© 2016 Dantes Elena et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
miliary tuberculosis, meningitis, stroke, nursing, rehabilitation