Limbic encephalitis associated with tuberculous mediastinal lymphadenitis

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Limbic encephalitis is an autoimmune disorder often linked to malignancies, infections, or systemic autoimmune diseases.
• Literature review reveals limited reports (two cases) of limbic encephalitis associated with tuberculosis.
• Tuberculosis (TB) can manifest with diverse neurological complications, though limbic encephalitis is infrequently documented.

Purpose of the Study:

• To report a case of limbic encephalitis associated with mediastinal tuberculous lymphadenitis.
• To emphasize the diagnostic role of endobronchial ultrasound (EBUS) in such cases.
• To highlight the successful treatment and clinical course of this rare association.

Main Methods:

• Case presentation of a 42-year-old male with non-resolving pneumonia.
• Diagnosis of limbic encephalitis and mediastinal tuberculous lymphadenitis confirmed via EBUS-guided needle aspirate.
• Therapeutic intervention with anti-tuberculous drugs.

Main Results:

• The patient presented with limbic encephalitis secondary to mediastinal tuberculous lymphadenitis.
• Paradoxical radiological progression observed during anti-TB therapy.
• Successful clinical and radiological improvement following treatment with anti-tuberculous drugs.

Conclusions:

• Limbic encephalitis should be considered a potential manifestation of central nervous system involvement in tuberculosis.
• Endobronchial ultrasound is an effective diagnostic tool for mediastinal tuberculous lymphadenitis.
• Anti-tuberculous therapy can effectively manage limbic encephalitis associated with TB.