結膜炎と両側海綿静脈洞への関与を伴う肺外結核症
Bilal Hassouneh1, Francesco Genderini2, Joachim G Schulz3
1Department of Ophthalmology, CHU Saint-Pierre, Brussels, Belgium.
IDCases
|December 31, 2025
まとめ
結核はまれに海綿静脈洞に影響を与え、神経学的症状を引き起こす可能性があります。神経画像検査や脳脊髄液検査が正常である場合があるため、診断には高い臨床的疑いと、しばしば頭蓋外生検が必要です。
科学分野:
- 神経学
- 感染症
- 放射線学
背景:
- 結核(TB)は世界的な健康問題であり、主に肺に影響を与えるが、多様な肺外症状を引き起こす可能性がある。
- TBによる神経学的関与はまれであるが、頭蓋神経麻痺や髄膜炎を含む重篤な合併症を引き起こす可能性がある。
- TBによる海綿静脈洞への関与は極めてまれであり、非特異的な臨床所見や画像所見を呈することが多く、診断上の課題となっている。
主な方法:
- 進行性の神経学的欠損を呈した41歳女性患者の詳細な症例報告。
- 連続的な磁気共鳴画像(MRI)、脳脊髄液(CSF)分析、QuantiFERON-TB Gold検査、18F-FDG PET-CT、およびリンパ節生検を含む包括的な診断ワークアップ。
- 4剤の抗結核レジメンと副腎皮質ステロイドによる治療。
結論:
- 海綿静脈洞結核症はまれな病態であり、肺病変がなく、初期所見が非特異的であることが多い。
- 神経画像検査やCSF分析の限界から、確定診断には頭蓋外生検が必要となる場合がある。
- 結核性海綿静脈洞症候群において、良好な転帰を得るためには、抗結核薬と副腎皮質ステロイドによる迅速な診断と治療が不可欠である。
関連する概念動画
Pulmonary Tuberculosis III
884
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
884
Pulmonary Tuberculosis II
1.3K
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
1.3K
Pulmonary Tuberculosis IV
467
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
467
Pulmonary Tuberculosis V
520
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
520
Pulmonary Tuberculosis I
801
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
801
Glaucoma: Overview
1.2K
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
1.2K


