Paediatric Tuberculous Meningitis Supported by Stool-Based GeneXpert and Complementary Radiologic Findings in Somalia: A Case Report
Clinical, Radiological, and Public Health Perspectives
DOI:
https://doi.org/10.36368/shaj.v6i1.1339Keywords:
Tuberculous meningitis; pediatric tuberculosis; extrapulmonary tuberculosis; stool GeneXpert; multidrug-resistant tuberculosis; magnetic resonance imaging; resource-limited settings, Somalia .Abstract
Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis in children and is associated with high morbidity and mortality, particularly in resource-limited settings where early diagnosis remains challenging. We report a paediatric case of TBM in Somalia in which microbiological support was obtained using stool-based GeneXpert testing alongside clinical and radiological findings.
An 11-year-old boy presented with a three-month history of weight loss, followed by nine weeks of intermittent fever and six weeks of persistent headache, with progressive neurological deterioration. Brain magnetic resonance imaging (MRI) showed diffuse enhancement of leptomeninges and basal cisterns due to TBM with communicating hydrocephalus. In addition, stool GeneXpert MTB/RIF showed the presence of multidrug-resistant Mycobacterium tuberculosis.
Despite initiation of appropriate second-line anti-tuberculous therapy, the patient’s condition deteriorated, and he died due to complications of advanced disease.
This report highlights the difficulties faced in diagnosing TBM in children and the serious results of delays in diagnosis. It also supports the potential role of stool-based molecular testing as a non-invasive diagnostic adjunct in children unable to produce respiratory specimens in resource-limited settings.
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Copyright (c) 2026 Ahmed Adam Osman
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