Figure 2: Post contrast MRI coronal section showing diffuse
leptomeningeal enhancement in bilateral cerebral hemispheres with
multiple enhancing nodular lesions in bilateral cerebral hemispheres,
basal ganglia and brainstem.
Along with the continuation of antitubercular therapy, the patient was
started on dexamethasone 4mg TDS for four weeks, which was tapered off
and stopped. During her hospital stay, she developed ATT-induced
hepatitis, for which she was kept in liver friendly regimen until
recovery. She was reinitiated on ATT after improvement in liver
function. The patient had developed pneumoperitoneum with
pneumomediastinum, which was managed conservatively.
At the time of discharge, she could walk without support and was
oriented to time place and person. Two weeks later, she presented with
fever and burning micturition, which was treated with appropriate
antibiotics. Her SARS COV-2 report was positive despite being previously
vaccinated with two doses of Vero cell vaccine. She was admitted to the
COVID-19 isolation ward, where her stay was uneventful. On the follow-up
visit, patient was doing fine and was taking intensive phase of ATT
drugs. Her steroid dosage was gradually tapered on follow up visit.