Intoxicación crónica por plaguicidas asociada a tuberculosis del sistema nervioso central: Reporte de caso

Milka Malena Prentice Mori; Julio Caleb Caleb  Arrieta Navarro; Jhordan Alexis Paredes Bernales; Heriberto Arévalo Ramírez

doi:10.1590/SciELOPreprints.14572

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Milka Malena Prentice Mori Universidad Nacional de San Martín https://orcid.org/0000-0002-3868-5661
- Validation
- Visualization
- Supervision
- Writing – Original Draft Preparation
- Project Administration
- Methodology
- Investigation
- Formal Analysis
- Data Curation
- Conceptualization
- Funding Acquisition
- Resources
- Writing – Review & Editing
Julio Caleb Caleb Arrieta Navarro Universidad Nacional de San Martín https://orcid.org/0009-0008-6100-2356
- Conceptualization
- Data Curation
- Formal Analysis
- Funding Acquisition
- Investigation
- Methodology
- Project Administration
- Resources
- Software
- Supervision
- Validation
- Visualization
- Writing – Original Draft Preparation
- Writing – Review & Editing
Jhordan Alexis Paredes Bernales Universidad Nacional de San Martín https://orcid.org/0000-0002-4098-2948
- Conceptualization
- Data Curation
- Formal Analysis
- Funding Acquisition
- Investigation
- Methodology
- Project Administration
- Resources
- Software
- Supervision
- Validation
- Visualization
- Writing – Original Draft Preparation
- Writing – Review & Editing
Heriberto Arévalo Ramírez Universidad Nacional de San Martín https://orcid.org/0000-0002-3252-6301
- Conceptualization
- Data Curation
- Formal Analysis
- Funding Acquisition
- Investigation
- Methodology
- Project Administration
- Resources
- Software
- Supervision
- Validation
- Visualization
- Writing – Original Draft Preparation
- Writing – Review & Editing

DOI:

https://doi.org/10.1590/SciELOPreprints.14572

Keywords:

Poisoning, pesticides, tuberculosis, neurotoxicity, occupational exposure, chronicity

Abstract

Chronic pesticide exposure in agricultural regions represents a public health problem linked to neuroinflammation and cognitive impairment. This case describes a 50-year-old farmer working in Tocache, exposed to pesticides without protective equipment. He presented with headache, neck stiffness, fever, insomnia, altered mental status, urinary retention, bradypsychia, hyperreflexia, blurred vision, micropsia, knee pain, and back pain. Cerebrospinal fluid analysis showed lymphocytic pleocytosis, hypoglycorrhachia, elevated protein, and a positive ADA test, leading to tuberculous meningitis despite negative cultures. Biochemistry revealed elevated protein in the cerebrospinal fluid, low serum protein, elevated GGT and LDH, and low urea. The diagnosis of central nervous system tuberculosis is complex due to the nonspecific nature of its symptoms and its paucibacillary nature, and pesticide exposure can predispose individuals to developing severe infections. The need to create sensitive diagnostic protocols and protective measures in agricultural areas is highlighted.

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Author Biographies

Milka Malena Prentice Mori, Universidad Nacional de San Martín

A neurologist and professor at the Faculty of Human Medicine of the National University of San Martín (Tarapoto, Peru), she currently works as a specialist in the Neurology Service of Hospital II-2 Tarapoto, where she participates in the clinical care, diagnosis, and management of patients with neurological pathologies, with a special interest in neurotoxicology, infectious diseases of the central nervous system, and occupational health in agricultural contexts.

Julio Caleb Caleb Arrieta Navarro, Universidad Nacional de San Martín

Human Medicine student at the Faculty of Medicine of the National University of San Martín (Tarapoto, Peru)

Jhordan Alexis Paredes Bernales, Universidad Nacional de San Martín

Human Medicine student at the Faculty of Medicine of the National University of San Martín (Tarapoto, Peru)

Heriberto Arévalo Ramírez, Universidad Nacional de San Martín

Microbiologist, with academic training linked to the Faculty of Human Medicine of the National University of San Martín (Tarapoto, Peru). He currently works at the San Martín Regional Public Health Reference Laboratory, where he leads microbiological diagnostic activities, epidemiological surveillance, and analysis of clinical samples in the context of infectious diseases of regional importance, including tuberculosis and other pathologies with an impact on public health.