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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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| 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. |
| format | Article |
| id | doaj-art-0729e9c9dcbc44aaa4e2a8dd2a173e91 |
| institution | Kabale University |
| issn | 2405-5794 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| 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 |
| work_keys_str_mv | AT zahrabakhshi intraspinalandintracranialneurotuberculosisacasereport AT mohammadibrahimashkaran intraspinalandintracranialneurotuberculosisacasereport AT saranazemsadati intraspinalandintracranialneurotuberculosisacasereport AT hosseinmojdehipanah intraspinalandintracranialneurotuberculosisacasereport AT zahrashafieikisomi intraspinalandintracranialneurotuberculosisacasereport |