Tuberculous meningitis complicated with thoracic cord myelitis; a diagnostic conundrum

Tuberculosis is known as the great masquerader for its ability to present atypically. We report a case of a young man presented with progressive tuberculous meningitis and subsequently developed paraplegia due to thoracic cord myelitis, where diagnosis was confirmed bacteriologically. We highlight t...

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Bibliographic Details
Published in:Sri Lanka Journal of Medicine
Main Authors: D. W. A. Shantha, D. Yasaratne, D. M. P. U. K. Ralapanawa, T. Jayalath, S. Abeyagunawardena, D. M. P. K. Dissanayake, W. J. B. S. M. S. Jayawardana
Format: Article
Language:English
Published: The Kandy Society of Medicine 2021-07-01
Subjects:
tuberculous meningitis
tuberculous myelitis
intravenous immunoglobulin
Online Access:https://account.sljm.sljol.info/index.php/sljo-j-sljm2/article/view/264
Description
Summary:Tuberculosis is known as the great masquerader for its ability to present atypically. We report a case of a young man presented with progressive tuberculous meningitis and subsequently developed paraplegia due to thoracic cord myelitis, where diagnosis was confirmed bacteriologically. We highlight the presence of acute gastric dilatation as a warning sign of thoracic cord involvement and the place for CSF examination and spinal imaging in arriving at a clinical diagnosis, as treatment needs to start without delay to avoid permanent sequelae. Patient showed a good response to a combined approach of anti-tuberculosis treatment, systemic steroids and intravenous immunoglobulin.
ISSN:2579-1990

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