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...

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Main Authors: Zahra Bakhshi, Mohammad Ibrahim Ashkaran, Sara Nazemsadati, Hossein Mojdehipanah, Zahra Shafiei Kisomi
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405579425000233
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author Zahra Bakhshi
Mohammad Ibrahim Ashkaran
Sara Nazemsadati
Hossein Mojdehipanah
Zahra Shafiei Kisomi
author_facet Zahra Bakhshi
Mohammad Ibrahim Ashkaran
Sara Nazemsadati
Hossein Mojdehipanah
Zahra Shafiei Kisomi
author_sort Zahra Bakhshi
collection DOAJ
description 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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publishDate 2025-08-01
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series Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
spelling doaj-art-0729e9c9dcbc44aaa4e2a8dd2a173e912025-08-20T03:57:58ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942025-08-014010053210.1016/j.jctube.2025.100532Intraspinal and intracranial Neurotuberculosis: A case reportZahra Bakhshi0Mohammad Ibrahim Ashkaran1Sara Nazemsadati2Hossein Mojdehipanah3Zahra Shafiei Kisomi4Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Neurosurgery, Rajaie Hospital, Qazvin University of Medical Sciences, Qazvin, IranAssisted Professor, Clinical Research Development Unit, Bu-Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, IranAssociate Professor of neurology, Bu-Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Medical-Surgical Nursing, Faculty of Nursing and midwifery, Tehran University of Medical Sciences, Tehran, Iran; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2405579425000233MeningitisTuberculousSpondylodiscitis
spellingShingle Zahra Bakhshi
Mohammad Ibrahim Ashkaran
Sara Nazemsadati
Hossein Mojdehipanah
Zahra Shafiei Kisomi
Intraspinal and intracranial Neurotuberculosis: A case report
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Meningitis
Tuberculous
Spondylodiscitis
title Intraspinal and intracranial Neurotuberculosis: A case report
title_full Intraspinal and intracranial Neurotuberculosis: A case report
title_fullStr Intraspinal and intracranial Neurotuberculosis: A case report
title_full_unstemmed Intraspinal and intracranial Neurotuberculosis: A case report
title_short Intraspinal and intracranial Neurotuberculosis: A case report
title_sort intraspinal and intracranial neurotuberculosis a case report
topic Meningitis
Tuberculous
Spondylodiscitis
url http://www.sciencedirect.com/science/article/pii/S2405579425000233
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AT mohammadibrahimashkaran intraspinalandintracranialneurotuberculosisacasereport
AT saranazemsadati intraspinalandintracranialneurotuberculosisacasereport
AT hosseinmojdehipanah intraspinalandintracranialneurotuberculosisacasereport
AT zahrashafieikisomi intraspinalandintracranialneurotuberculosisacasereport