一种不寻常的脊柱结核病呈现,伪装成炎性脑膜炎:一个病例报告
Parackrama Karunathilake1, Sanjeewa Bowatte1, Prabhashini Kumarihamy1
1Department of Medicine, Faculty of Medicine, Wayamba University of Sri Lanka, Kuliyapitiya, Sri Lanka, wyb.ac.lk.
脊髓结核可以模仿细菌性脑膜炎,有异常的脑脊液发现. 早期诊断和治疗对于患有发烧,神经缺陷和多细胞瘤的患者至关重要,特别是在流行地区.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 脊柱结核病 (TB) 占骨结核病的50%.
- 它经常以背部疼痛,形变形或神经系统缺陷的阴险方式呈现.
- 非典型的呈现,如CSF中中性质细胞瘤,可以模仿细菌性脑膜炎.
研究的目的:
- 为了突出脊柱结核病的非典型表现.
- 强调在差异诊断中考虑脊柱结核病的重要性.
- 强调早期诊断和治疗的必要性.
主要方法:
- 一个46岁的男性的病例报告.
- 最初的呈现模仿细菌性脑膜炎,伴有发烧,头痛,部硬和中性性脑液多细胞症.
- 诊断工作包括MRI脊柱和CSFPCR用于*Mycobacterium结核病*.
主要成果:
- 患者尽管服用经验性抗生素,但患有和高血压.
- 核磁共振扫描显示了脊椎体的参与和压缩性骨髓病.
- 脊髓灰质炎PCR证实了*Mycobacterium tuberculosis*,导致抗结核治疗和皮质类固醇显著改善临床状况.
结论:
- 临床医生必须怀疑脊柱结核病在患有持续发烧,神经症状和CSF多细胞症的患者,即使怀疑细菌性脑膜炎.
- 高可疑指数至关重要,特别是在结核病流行地区.
- 早期成像和向治疗显著改善脊柱结核病的结果.
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