椎管内及颅内神经结核1例

IF 1.9 Q3 INFECTIOUS DISEASES
Zahra Bakhshi , Mohammad Ibrahim Ashkaran , Sara Nazemsadati , Hossein Mojdehipanah , Zahra Shafiei Kisomi
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引用次数: 0

摘要

结核性脑膜炎(TBM)是最具破坏性的结核病(TB)形式,造成高死亡率或致残。结核性脑膜炎的诊断由于其发病迅速和非特异性症状而特别困难。早期发现和有针对性的治疗是确保结核病得到控制的主要手段。这里我们报告一例结核性脑膜炎的非特异性症状,包括精神和认知障碍伴随髂腰肌脓肿和脊柱炎。病例报告我们在此报告一位38岁亚洲男性的TBM病例。他表现为行为改变、背部疼痛、进行性行走障碍和头痛。胸椎和腰骶部MRI表现为Gibbus畸形伴胸椎椎间盘炎和双侧髂腰肌脓肿。脑MRI发现包括基底脑膜增强。他开始接受抗结核治疗。住院期间,患者意识水平下降,住进重症监护病房。手术矫正后凸畸形,患者入院后约两个月出院。结论结核可能是急性细菌性脑膜炎的重要病因,在逐渐进行性精神和认知障碍或精神病性怪异行为的患者中,通常以发热性疾病的形式出现,导致早期诊断失败。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intraspinal and intracranial Neurotuberculosis: A case report

Background

Tuberculosis meningitis (TBM) is the most devastating form of tuberculosis (TB), causing high mortality or disability. The diagnosis of tuberculous meningitis is notably difficult due to its rapid onset and nonspecific symptoms. Early recognition and targeted treatment are the principal means of ensuring tuberculosis control. Here we report a case of tuberculosis meningitis with nonspecific symptoms including mental and cognitive impairments concomitant to Iliopsoas muscle abscess and spondylodiscitis.

Case presentation

Here we describe a case of TBM in a 38- year- old Asian male. He presented with behavioral change, back pain, progressive walking impairment and headache. Thoracic and lumbosacral MRI demonstrated Gibbus deformity with thoracic spondylodiscitis and bilateral Iliopsoas muscle abscess. Brain MRI finding included basal leptomeningeal enhancement. He was started on antituberculous therapy. During hospitalization, the patient’s level of consciousness decreased, and he was admitted to the intensive care unit. Surgery for correct kyphotic deformity was done, and the patient discharged about two months after admission.

Conclusion

Tuberculosis should be considered as a possible important etiology of acute bacterial meningitis that may commonly present as an afebrile illness in patients with gradually progressive mental and cognitive impairments or psychotic bizarre behaviors which leads to failure of early diagnosis.
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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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