Tuberculous meningitis presenting as an obstructive myelopathy. Case report

Area of Science:

• Neurology
• Infectious Diseases
• Pathology

Background:

• Tuberculous meningitis (TBM) is a severe infection of the central nervous system.
• Spinal cord compression can lead to neurological deficits, including paraplegia.
• Pott's disease, vertebral tuberculosis, is a common cause of spinal tuberculosis.

Observation:

• A patient presented with subacute paraplegia over three months.
• The paraplegia was caused by spinal cord compression.
• The patient had a normal chest X-ray and no evidence of Pott's disease.

Findings:

• The cause of spinal cord compression and paraplegia was tuberculous meningitis.
• The meningitis was characterized by proliferative granulomatous inflammation leading to obstructive myelopathy.
• This presentation is highly unusual for tuberculous meningitis, lacking typical radiological signs.

Implications:

• This case underscores the diverse and sometimes atypical presentations of tuberculous meningitis.
• It highlights the importance of considering TBM in cases of unexplained spinal cord compression, even without overt signs of tuberculosis elsewhere.
• Further research into rare neurological manifestations of TBM is warranted.