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Skull base and calvarial tuberculosis presenting as chronic meningitis
Sanjeev Kumar Bhoi1, Suprava Naik2, Menka Jha1
1Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India.
The Indian Journal of Tuberculosis
|August 23, 2020
Summary
Calvarial tuberculosis, a rare condition affecting the skull, presents diagnostic challenges. Early suspicion and prompt antitubercular treatment are crucial for successful management and lesion resolution.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Calvarial tuberculosis is an exceptionally rare form of skeletal tuberculosis, comprising only 0.2-1.3% of cases.
- Diagnosis is often complicated by insidious onset, minimal bacterial presence, and difficult sample collection from affected skull sites.
- Adjacent meningeal involvement can lead to presentations mimicking meningitis.
Observation:
- This case report details a patient with tubercular involvement of the sphenoid, clivus, and frontal bone.
- The patient presented with symptoms mimicking chronic meningitis due to adjacent meningeal inflammation.
Findings:
- Diagnosis was confirmed through advanced radiological imaging and histopathological examination.
- The tubercular lesions showed significant resolution after a 5-month course of antitubercular therapy.
Implications:
- Highlights the necessity of a high index of suspicion for diagnosing calvarial tuberculosis, especially when presenting with neurological symptoms.
- Emphasizes the effectiveness of timely antitubercular treatment in managing this rare condition.
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