Disseminated tuberculosis manifesting as pulmonary, meningeal and spinal tuberculosis in an immunocompetent patient (original) (raw)
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Extensive Multisystemic Disseminated Tuberculosis in an Immunocompetent Patient
The Journal of clinical and aesthetic dermatology, 2018
Extrapulmonary tuberculosis is uncommon and has an insidious onset with slow evolution and a paucibacillary nature. Here, we present a case of disseminated tuberculosis in an adult immunocompetent man presenting with morphologically different types of cutaneous lesions (i.e., multiple subcutaneous abcesses and multiple noduloulcerative lesions with discharging sinuses with seropurulent fluid). Extensive screening in the form of routine blood investigations, serologies, skin biopsy, Montoux test, sputum examination, chest and skull roentgenogram, noncontrast computed tomography chest and abdomen, contrast-enhanced computed tomography of the skull, and magnetic resonance imaging of lumbosacral spine with screening of the whole spine revealed extensive involvement of the skin, subcutaneous tissue, lungs, lymph nodes, skull bone, mandible, ribs, scapula, pelvis and Pott's spine, and thyroid.
Romanian Journal of Neurology
Background/aim. Mycobacterium tuberculosis (M. tuberculosis) infection can cause pulmonary and extrapulmonary tuberculosis (TB), resulted from hematogenous or lymphatic dissemination of the bacteria. Disseminated TB is characterized by the presence of two or more non-contiguous sites from the spread. Dissemination to the central nervous system (CNS TB) has several manifestations that can cause devastating neurological complications. Several predisposing factors include older age, human immunodeficiency virus (HIV) coinfection, and pharmacological immunosuppression. As the manifestation of CNS TB itself is rare, diagnosing it remains a challenge. Prompt antituberculosis treatment is needed to improve patient’s outcome. This paper aims to present a rare case of malignant disseminated TB in a young immunocompetent patient. Case. This case presents an immunocompetent 17-year-old male with weakness in the four extremities. Through comprehensive history taking and examination, the patient...
Intracranial and Spinal Tuberculosis: A Rare Entity
Cureus, 2021
CNS tuberculosis has a broad spectrum of disease patterns and a high risk of complications and mortality. We present a case of a 36-year-old man who was diagnosed with neurotuberculosis with intracranial and spinal tuberculomas, meningitis, and spondylodiscitis. The patient was a known case of sarcoidosis and was being managed on corticosteroids. His presenting complaints were headache, low-grade fever, severe backache, lower limb weakness, and one episode of altered sensorium. The initial diagnosis was based on imaging findings, which were confirmed with positive cerebrospinal fluid (CSF) culture for Mycobacterium tuberculosis. Imaging and clinicopathological correlation enables early diagnosis and treatment and prevents permanent neurological sequelae.
Case reports in neurological medicine, 2018
We herein report a rare case of a 25-year-old immunocompetent male patient with disseminated tuberculosis of central nervous system (CNS), first presenting as multiple cerebral lesions with no meningeal involvement. Subsequent diagnostic workup disclosed extensive peritoneal involvement. A broad differential diagnosis was considered, including neoplastic and infectious diseases. The diagnosis was confirmed with positive PCR result for in the biopsied mesenteric tissue. The patient was started on tuberculostatic regimen with favorable outcome. No acquired or hereditary immunodeficiency was documented. Disseminated tuberculosis in immunocompetent individuals is extremely rare. Genetic susceptibility factors have been reported in individuals with extensive forms of the disease and a high index of suspicion is required, as observed in our case.
Central Nervous System Tuberculosis- Case Report Case Report
Journal of Morphological Sciences
Mycobacterium tuberculosis is the leading cause of morbidity and mortality worldwide. Tuberculosis is the second most common cause of death due to an infectious agent worldwide after COVID-19 infection. Central nervous system tuberculosis, accounts for approximately 1% of all cases of tuberculosis, and the most common clinical presentation is tuberculous meningitis. Tuberculosis of the central nervous system is a devastating disease that, even under appropriate antituberculin therapy, leads to a high mortality rate. In this paper, we present a case report of a patient in whom the disease begins slowly, progressively, and chronically, with the initial clinical manifestation of dementia syndrome. Usually, tuberculous meningitis presents with a subacute progressive febrile illness. In 2 to 3 weeks defines meningitis phase with headache, meningismus, vomiting, mild confusion. Rare is the atypical presentation of CNS TB, as in our case. During the hospitalization, brain magnetic resonance was performed with suspicious findings for neuro infection. Due to the suspected finding of magnetic resonance imaging, a lumbar puncture was performed and the cerebrospinal fluid was sent for analysis for specific causes, including Mycobacterium tuberculosis. Correct diagnosis and therapy in these patients are a challenge for neurologists.
Tuberculosis from Head to Toe1
RadioGraphics, 2000
Tuberculosis can affect virtually any organ system in the body and can be devastating if left untreated. The increasing prevalence of tuberculosis in both immunocompetent and immunocompromised individuals in recent years makes this disease a topic of universal concern. Because tuberculosis demonstrates a variety of clinical and radiologic findings and has a known propensity for dissemination from its primary site, it can mimic numerous other disease entities. Primary pulmonary tuberculosis typically manifests radiologically as parenchymal disease, lymphadenopathy, pleural effusion, miliary disease, or lobar or segmental atelectasis. In postprimary tuberculosis, the earliest radiologic finding is the development of patchy, ill-defined segmental consolidation. Both computed tomography (CT) and magnetic resonance (MR) imaging are helpful in diagnosing tuberculous spondylitis and tuberculous Top Abstract Introduction Pulmonary Tuberculosis Cardiac Tuberculosis Skeletal Tuberculosis Tuberculous Arthritis Gastrointestinal Tuberculosis Genitourinary Tuberculosis Tuberculosis Involving the... Tuberculous Otomastoiditis Ocular Tuberculosis Conclusions References arthritis. CT is especially useful in depicting gastrointestinal and genitourinary tuberculosis. In tuberculosis involving the central nervous system, CT and MR imaging findings vary depending on the stage of disease and the character of the lesion. A high degree of clinical suspicion and familiarity with the various radiologic manifestations of tuberculosis allow early diagnosis and timely initiation of appropriate therapy, thereby reducing patient morbidity.