John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (BKC).
Family Medicine Residency Program, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (JA).
Hawaii J Health Soc Welf. 2022 Jun;81(6):151-154.
The uncommon presentation of simultaneous brain and lung lesions in an immunocompetent adult patient with frequent travel to a mycobacterium tuberculosis (MTB) endemic area requires high clinical suspicion for central nervous system (CNS) MTB, as this disease often results in severe neurologic morbidity and mortality. Non-specific and subacute symptoms make the diagnosis of CNS MTB clinically challenging, and a workup with imaging and microbiological studies such as acid-fast bacilli staining, nucleic acid amplification testing, and tissue culture must not delay prompt treatment with anti-tuberculosis therapy. This case illustrates the complex challenges of medical diagnosis and multi-disciplinary decision-making involved in the workup of CNS MTB.
一位常前往结核分枝杆菌（MTB）流行地区的免疫功能正常的成年患者出现脑和肺同时受累的罕见表现时，需要高度怀疑中枢神经系统（CNS）MTB，因为该病常导致严重的神经发病率和死亡率。非特异性和亚急性症状使得 CNS MTB 的临床诊断具有挑战性，必须进行影像学和微生物学检查，例如抗酸杆菌染色、核酸扩增检测和组织培养，以明确诊断，但不能因此而延迟及时开始抗结核治疗。本病例说明了在 CNS MTB 的检查中涉及到的医学诊断和多学科决策的复杂挑战。
