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An adolescent Pakistani girl with chronic meningitis
C E Clarke, P S Ray, H A Abdelhadi
Department
of Neurology, Hull Royal Infirmary, Hull,
HU3 2JZ, UK
Accepted 3 June 1998
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
In August 1994, a 19-year-old Pakistani girl developed
nausea and vomiting while on holiday in Pakistan from her home in the UK. For the preceding 12 months, she had undergone unrewarding investigations of non-specific abdominal pain, loss of appetite, unexplained weight loss and secondary amenorrhoea. After 2 days, she
was admitted to a hospital in Pakistan with rapid deterioration of
conscious level resulting in coma. On examination, she had neck
stiffness and a positive Kernig's sign but no other focal neurological
deficit. A computed tomography scan showed dense meningeal enhancement
but no focal intraparenchymal lesion. An electroencephalogram (EEG)
showed gross generalised slowing with diffuse delta waves. A lumbar
puncture was performed which showed the cerebrospinal fluid (CSF) to
contain 198 × 106 leucocytes/l with 95% lymphocytes. The
CSF glucose was 2.4 mmol/l with increased protein of 2.09 g/l. Culture
and sensitivity, staining for acid/alcohol-fast bacilli and India ink
test were negative. Tests for malaria were negative. She
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