Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report
A 10 year old female presented with fever, headache and vomiting since four days. Her laboratory workup revealed low serum sodium, serum osmolality. CT scan of the brain was unremarkable, while on CSF examination, protein, and total leukocyte count (predominantly lymphocytes) were increased. CSF cul...
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| Language: | English |
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Bahria Univerisy Health Sciences, Campus Karachi
2024-01-01
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| Series: | Journal of Bahria University Medical and Dental College |
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| Online Access: | https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/1358 |
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| author | Yousra Nasir Siddiqui |
| author_facet | Yousra Nasir Siddiqui |
| author_sort | Yousra Nasir Siddiqui |
| collection | DOAJ |
| description | A 10 year old female presented with fever, headache and vomiting since four days. Her laboratory workup revealed low serum sodium, serum osmolality. CT scan of the brain was unremarkable, while on CSF examination, protein, and total leukocyte count (predominantly lymphocytes) were increased. CSF cultures were negative, however, GeneXpert detected rifampicin resistant mycobacterium tuberculosis. Due to her high urine output and hyponatremia with sodium of 128 mEq/l, fluid restriction was attempted in order to rule out the diagnosis of SIADH, but the patient was unresponsive to it. Thus, the patient was diagnosed with tuberculous meningitis after further workup, followed by cerebral salt wasting. She was started on anti-tuberculous therapy (ATT), 3% hypertonic saline and flucrocortisone, to which she was responsive, and eventually discharged. |
| format | Article |
| id | doaj-art-b27e7cfdc8334312ae4d69f4d9e5722e |
| institution | DOAJ |
| issn | 2220-7562 2617-9482 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Bahria Univerisy Health Sciences, Campus Karachi |
| record_format | Article |
| series | Journal of Bahria University Medical and Dental College |
| spelling | doaj-art-b27e7cfdc8334312ae4d69f4d9e5722e2025-08-20T02:45:03ZengBahria Univerisy Health Sciences, Campus KarachiJournal of Bahria University Medical and Dental College2220-75622617-94822024-01-011401939510.51985/JBUMDC20232701358Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case ReportYousra Nasir SiddiquiA 10 year old female presented with fever, headache and vomiting since four days. Her laboratory workup revealed low serum sodium, serum osmolality. CT scan of the brain was unremarkable, while on CSF examination, protein, and total leukocyte count (predominantly lymphocytes) were increased. CSF cultures were negative, however, GeneXpert detected rifampicin resistant mycobacterium tuberculosis. Due to her high urine output and hyponatremia with sodium of 128 mEq/l, fluid restriction was attempted in order to rule out the diagnosis of SIADH, but the patient was unresponsive to it. Thus, the patient was diagnosed with tuberculous meningitis after further workup, followed by cerebral salt wasting. She was started on anti-tuberculous therapy (ATT), 3% hypertonic saline and flucrocortisone, to which she was responsive, and eventually discharged.https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/1358siadh; tuberculous meningitis; cerebral salt wasting; hyponatremia; fludrocortisone |
| spellingShingle | Yousra Nasir Siddiqui Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report Journal of Bahria University Medical and Dental College siadh; tuberculous meningitis; cerebral salt wasting; hyponatremia; fludrocortisone |
| title | Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report |
| title_full | Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report |
| title_fullStr | Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report |
| title_full_unstemmed | Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report |
| title_short | Hyponatremia in Tuberculosis Meningitis: Navigating the Diagnostic Challenges of Cerebral Salt Wasting – A Case Report |
| title_sort | hyponatremia in tuberculosis meningitis navigating the diagnostic challenges of cerebral salt wasting a case report |
| topic | siadh; tuberculous meningitis; cerebral salt wasting; hyponatremia; fludrocortisone |
| url | https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/1358 |
| work_keys_str_mv | AT yousranasirsiddiqui hyponatremiaintuberculosismeningitisnavigatingthediagnosticchallengesofcerebralsaltwastingacasereport |