免疫功能正常患者的中枢神经系统结核瘤合并脊髓蛛网膜炎
Central Nervous System Tuberculoma Complicated with Spinal Arachnoiditis in Immunocompetent Patient.
作者信息
Suryapraba A A Ayu, Susilawathi Ni Made, Niryana I Wayan
机构信息
Neurology Department, Faculty of Medicine, Udayana University, Sanglah Hospital Denpasar, Denpasar, Bali, Indonesia.
Neurology Department, Faculty of Medicine, Udayana University, Udayana University Hospital Jimbaran, Jimbaran, Bali, Indonesia.
出版信息
Open Access Maced J Med Sci. 2019 Jun 30;7(12):2002-2005. doi: 10.3889/oamjms.2019.272.
BACKGROUND
Central nervous system (CNS) tuberculosis (TB) can manifest as meningitis, abscess, tuberculoma or other manifestations. CNS TB is a rare TB complication, and its diagnosis remains a challenge since it has clinical and imaging features that resemble other diseases. The antituberculosis treatment has a significant role in determining a patient's outcome and prevent complications and mortality.
CASE PRESENTATION
Here, we report a case of CNS TB manifested as tuberculoma in immunocompetent patient complicated with spinal arachnoiditis. Despite a treatment delay, the patient still showed clinical improvement after proper treatment with a combination of antituberculosis drug and corticosteroid.
CONCLUSION
Central Nervous System Tuberculoma Complicated with Spinal Arachnoiditis in Immunocompetent Patient CNS tuberculoma is a rare CNS TB manifestation, and its diagnosis remain a challenge since its clinical symptoms and radiological findings could mimic other cases such as malignancy, pyogenic abscess, toxoplasmosis, sarcoidosis, or neurocysticercosis.
背景
中枢神经系统（CNS）结核可表现为脑膜炎、脓肿、结核瘤或其他表现。CNS结核是一种罕见的结核并发症，由于其临床和影像学特征与其他疾病相似，其诊断仍然是一项挑战。抗结核治疗在决定患者的预后以及预防并发症和死亡方面具有重要作用。
病例报告
在此，我们报告一例免疫功能正常的患者发生中枢神经系统结核，表现为结核瘤并伴有脊髓蛛网膜炎。尽管治疗延迟，但患者在接受抗结核药物和皮质类固醇联合恰当治疗后仍显示出临床改善。
结论
免疫功能正常患者的中枢神经系统结核瘤合并脊髓蛛网膜炎 中枢神经系统结核瘤是一种罕见的中枢神经系统结核表现，由于其临床症状和影像学表现可能与其他病例（如恶性肿瘤、化脓性脓肿、弓形虫病、结节病或神经囊尾蚴病）相似，其诊断仍然是一项挑战。
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