Nutritional Therapy For Tuberculous Meningitis Patient : Case Report

Treatment for tuberculosis meningitis and nutritional therapy is needed to reduce morbidity and mortality and prevent malnutrition. Calculation of energy requirements and the regulation of macronutrient and micronutrient composition that is adequate can maintain lean body mass, prevent metabolic complications, and improve the immune system, cognitive and functional capacity. We reported a 25-year-old severe malnourished female patient was consulted by a neurologist with tuberculous meningitis. The chief complaint was no intake since last 2 days because of loss consciousness. History of decreased food intake since 8 months ago. There were fever, cough and a history of headache. On physical examination, we found sign of anemia, loss of subcutaneous fat and muscle wasting. From laboratory examination, there were normocytic normochromic anemia, leucocytosis, severe immune depletion, hypoalbuminemia and hyponatremia. Nutritional therapy was given gradually with target energy 1650 kcal and protein 1.5 g /kg IBW/day (75.6 g) through enteral and parenteral. Supplementation were vitamin A, B complex, C, D, zinc, and snake head fish extract high content protein albumin (Pujimin®), immunonutrient such as glutamine. After 11-day treatment, there were increased plasma albumin, lymphocyte level and functional capacity. Adequate macro and micronutrient intake and glutamine supplementation are important in TB meningitis patients with decreased awareness so as to improve nutritional status, patient clinical condition and functional capacity


Josephine Thewakan, Haerani Rasyid

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