Occult disseminated tuberculosis with holocord longitudinally extensive transverse myelitis: A rare phenomenon in a child

Alkan, Gülsüm; Emiroğlu, Melike; Peru, Harun; Koplay, Mustafa

doi:10.4103/jpn.jpn_14_17

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…It has been reported that CNS TB comprises 1% of all TB infections, with 95% of these in the form of TB meningitis and half of them involving the spine[ 23 , 24 ]. Tuberculous myelitis is usually due to hematogenous spread or compression via spinal TB[ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report

Gu¹,

Tian²,

Yan³

2021

WJCC

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BACKGROUND Tuberculous myelitis is a rare manifestation of tuberculosis (TB) that is usually caused by hematogenous spread of Mycobacterium tuberculosis (MTB). Neurosyphilis is a neurological disease that occurs when Treponema pallidum invades the brain or the spinal cord. Individually, these two diseases involving the spinal cord are rare and cases of concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis have seldom been reported. CASE SUMMARY A 56-year-old man presented with numbness and pain of both lower limbs for 2 wk and dysuria for 1 wk. Syphilis serology and cerebrospinal fluid (CSF) analysis supported the diagnosis of neurosyphilis and the patient was treated with intravenous ceftriaxone at first, but symptoms still progressed. Then, magnetic resonance images revealed multiple lesions along the cervicothoracic junction, and chest computed tomography showed a typical TB lesion. MTB DNA was detected in the CSF sample by metagenomic next-generation sequencing. Eventually the patient was diagnosed with tuberculous myelitis combined with asymptomatic neurosyphilis. Subsequently, quadruple anti-TB drug standardized therapy was empirically used and his neurological symptoms improved gradually. CONCLUSION Patients can have coinfection with tuberculous transverse myelitis and asymptomatic neurosyphilis. Patients with neurosyphilis should be examined for other pathogens.

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Section: Discussionmentioning

confidence: 99%

Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report

Gu¹,

Tian²,

Yan³

2021

WJCC

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“…Previous reports have considered a combination of steroid and antitubercular therapy to be appropriate. 3 4 18 41 42 43 44 Antiretroviral therapy may be added to the treatment regime for patients with HIV. All of the reported patients analyzed in this review received a combination of steroid and antitubercular therapy, with follow-up clinical and radiological improvements evident in most of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…2 The clinical manifestation depends on the organ system affected. TB of the central nervous system (CNS) comprises 1% of all TB infections, with 95% of these in the form of TB meningitis 3 4 and half of them involving the spine. TB is an airborne infectious disease caused by the Mycobacterium tuberculosis complex that was discovered in 1882 by Robert Koch.…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Myelopathy Associated with Longitudinally Extensive Lesion: A Clinicoradiological Review of Reported Cases

2020

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Acute transverse myelitis is an inflammatory disorder of the spinal cord in which there is no evidence of spinal cord compression. Longitudinally extensive transverse myelitis (LETM) is a specific subtype of acute transverse myelitis that usually affects three or more vertebral levels and produces marked neurological deficits. While the most-common cause of LETM is neuromyelitis optica or neuromyelitis optica spectrum disorder, there are rare cases of other causes mimicking this condition, including tuberculosis (TB). We sought to review the clinicoradiological features of TB myelopathy associated with longitudinally extensive lesion, which may mimic LETM, in the English literature. We searched the PubMed, Google Scholar, Web of Science, and Scopus databases for relevant articles using search terms including "longitudinally extensive transverse myelitis, " "tuberculosis, " "TB spinal cord, " and various combinations of these expressions. Full-text papers were selected without limiting the publication year. We also examined the reference lists of key papers to identify further articles that are potentially relevant. We found 10 cases in 7 papers describing TB myelopathy associated with longitudinally extensive lesion. The demographics, clinical features, relevant cerebrospinal fluid findings, and radiological findings were compiled and summarized. TB myelopathy associated with longitudinally extensive lesion is very rare, with no documented prevalence. Early and accurate diagnosis is important since the condition is potentially treatable.

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“…Although rare in children, holocord involvement was also described in occult disseminated tuberculosis. 5 As LETM is the cardinal manifestation of NMOSDs, thorough evaluation should be done for early diagnosis and for the possible secondary etiologies including infections, connective tissue disorders, etc. Serum aquaporin 4 antibody positivity is highly variable and can be negative in the context of classical clinical features.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Tuberculosis with Longitudinally Extensive Transverse Myelitis

Ramineni

Jakkani

Swamy

et al. 2020

JNRP

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Longitudinally extensive transverse myelitis (LETM) is described in neuromyelitis optica spectrum disorders. Simultaneous active pulmonary tuberculosis in these disorders is a relatively rare phenomenon. We report a 16 year-old boy diagnosed as LETM with clinicoradiological correlation. Further evaluation revealed active pulmonary tuberculosis. He had good recovery following the combination of antituberculosis regimen with corticosteroids. AbstractKeywords ► corticosteroids ► longitudinally extensive transverse myelitis ► pulmonary tuberculosis

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Occult disseminated tuberculosis with holocord longitudinally extensive transverse myelitis: A rare phenomenon in a child

Cited by 7 publications

References 8 publications

Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report

Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report

Tuberculous Myelopathy Associated with Longitudinally Extensive Lesion: A Clinicoradiological Review of Reported Cases

Pulmonary Tuberculosis with Longitudinally Extensive Transverse Myelitis

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