{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:43:02Z","timestamp":1793148182282,"version":"4.5.0"},"reference-count":12,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,8,27]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>We herein report a case of a child with tuberculous meningitis and COVID-19 coinfection complicated by hydrocephalus, arterial ischaemic stroke and extensive cerebral sinus venous thrombosis. Both conditions induce a proinflammatory cytokine drive resulting, among others, in a prothrombotic state. The disruption of the coagulation system in this case was supported by elevated D-dimers, fibrinogen and ferritin levels, consistent with thrombotic complications reported in some adult patients infected with COVID-19. The child also exhibited prolonged viral shedding that suggests severe disease.<\/jats:p>","DOI":"10.1136\/bcr-2020-238597","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T17:19:04Z","timestamp":1600103944000},"page":"e238597","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Child with tuberculous meningitis and COVID-19 coinfection complicated by extensive cerebral sinus venous thrombosis"],"prefix":"10.1136","volume":"13","author":[{"given":"Farida","family":"Essajee","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5607-8443","authenticated-orcid":false,"given":"Regan","family":"Solomons","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-1307","authenticated-orcid":false,"given":"Pierre","family":"Goussard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Van Toorn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,14]]},"reference":[{"key":"2025082701460049000_13.9.e238597.1","unstructured":"COVID-19 in the who African region. Available: https:\/\/who.maps.arcgis.com\/apps\/opsdashboard\/index.html#\/0c9b3a8b68d0437a8cf28581e9c063a9"},{"key":"2025082701460049000_13.9.e238597.2","unstructured":"World Health Organization . Global tuberculosis report. Geneva, Switzerland: WHO Report, 2018."},{"key":"2025082701460049000_13.9.e238597.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-018-5252-9","article-title":"Complementary surveillance strategies are needed to better characterise the epidemiology, care pathways and treatment outcomes of tuberculosis in children","volume":"18","author":"du Preez","year":"2018","journal-title":"BMC Public Health"},{"key":"2025082701460049000_13.9.e238597.4","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6644"},{"key":"2025082701460049000_13.9.e238597.5","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.neurol.2020.04.013","article-title":"First case of Covid-19 presented with cerebral venous thrombosis: a rare and dreaded case","volume":"176","author":"Hemasian","year":"2020","journal-title":"Rev Neurol"},{"key":"2025082701460049000_13.9.e238597.6","article-title":"Cerebral venous thrombosis associated with COVID-19 infection: causality or coincidence?","author":"Poillon","year":"2020","journal-title":"J Neuroradiol"},{"key":"2025082701460049000_13.9.e238597.7","doi-asserted-by":"publisher","DOI":"10.12890\/2020_001691"},{"key":"2025082701460049000_13.9.e238597.8","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-rcpch.1"},{"key":"2025082701460049000_13.9.e238597.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000261126.60283.cf"},{"key":"2025082701460049000_13.9.e238597.10","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-231419","article-title":"Multiple cerebral sinus venous thrombosis and venous infarct: rare complication of tuberculous meningitis in a child","volume":"12","author":"Sharawat","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082701460049000_13.9.e238597.11","doi-asserted-by":"crossref","unstructured":"Natarajan V , George S , Eapen G , et al . An unusual association \u2013 tuberculous meningitis causing cerebral venous thrombosis. Journal of Case Reports 2015:343\u20136.doi:10.17659\/01.2015.0088","DOI":"10.17659\/01.2015.0088"},{"key":"2025082701460049000_13.9.e238597.12","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/S1473-3099(20)30232-2","article-title":"Viral dynamics in mild and severe cases of COVID-19","volume":"20","author":"Liu","year":"2020","journal-title":"Lancet Infect Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:46:12Z","timestamp":1756284372000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":12,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,14]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bcr-2020-238597"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238597","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}