Disseminated tuberculosis presenting as meningitis and spondylodiscitis in an immunocompetent adult  

作　　者：Jeyapraniya Arumugam Shamila De Silva 

机构地区：[1]University Medical Unit,Colombo North Teaching Hospital,Ragama,Sri Lanka [2]Faculty of Medicine,University of Kelaniya,Sri Lanka

出　　处：《Asian Pacific Journal of Tropical Medicine》2023年第6期284-286,共3页亚太热带医药杂志（英文版）

摘　　要：Rationale:Disseminated tuberculosis involves the central nervous system in up to a third of cases.However,meningitis and spondylodiscitis due to miliary tuberculosis rarely occur together,particularly in the immuno-competent population.Patient concerns:A 37-year-old immunocompetent male presented with altered level of consciousness for one week and lower back pain with evening pyrexia for one month.Examination revealed spastic paraplegia and left hemiparesis.Diagnosis:Disseminated tuberculosis presenting with meningitis and spondylodiscitis.Interventions:Category I anti-tuberculous therapy with a tapering regimen of intravenous dexamethasone was administered.Outcomes:There was clinical improvement after nine months of treatment.Lessons:Tuberculosis may present with atypical clinical manifestations.Contrast enhanced computed tomography scan or magnetic resonance imaging combined with histopathological features,a high index of suspicion and clinical improvement with anti-tuberculous treatment can confirm the diagnosis in the absence of microbiological evidence,especially in extrapulmonary tuberculosis.

关 键 词：Disseminated tuberculosis IMMUNOCOMPETENT SPONDYLODISCITIS MENINGITIS Miliary tuberculosis 

分 类 号：R519[医药卫生—内科学]