Yu Yachun, He Guohua
Department of Neurology, The Affiliated Changsha Central Hospital, University of South China, Changsha, Hunan 410000, P.R. China.
Exp Ther Med. 2024 Apr 23;27(6):260. doi: 10.3892/etm.2024.12548. eCollection 2024 Jun.
Central nervous system (CNS) tuberculosis mainly manifests as tuberculous meningitis and intracranial tuberculosis; intramedullary tuberculosis is uncommon. Scrub typhus is an acute naturally occurring infectious disease caused by . CNS tuberculoma following typhus is rare. The present study described a 60-year-old man with high fever, muscle soreness, yellowish skin and sclera and hepatosplenomegaly. At first, the patient was diagnosed with scrub typhus, after treatment with doxycycline he recovered completely. However, half a month after discharge, the patient experienced headache, night sweats and anorexia. Tuberculosis-specific enzyme-linked immunospot assay showed positive Mycobacterium tuberculosis antibody in cerebrospinal fluid (CSF). Metagenomic next-generation sequencing detected the presence of in CSF. Magnetic resonance imaging of the brain and spinal cord showed multiple rings enhancing lesions in the cerebral hemispheres, cerebellum, brainstem and spinal cords. After the diagnosis of CNS tuberculoma, the patient was started on conventional anti-tuberculosis therapy resulting in a good prognosis.
中枢神经系统（CNS）结核主要表现为结核性脑膜炎和颅内结核；脊髓结核并不常见。恙虫病是一种由……引起的急性自然发生的传染病。恙虫病后发生的中枢神经系统结核瘤很罕见。本研究描述了一名60岁男性，有高热、肌肉酸痛、皮肤和巩膜黄染以及肝脾肿大。起初，该患者被诊断为恙虫病，用多西环素治疗后完全康复。然而，出院半个月后，患者出现头痛、盗汗和厌食。结核特异性酶联免疫斑点试验显示脑脊液（CSF）中结核分枝杆菌抗体呈阳性。宏基因组下一代测序检测到脑脊液中存在……。脑和脊髓的磁共振成像显示大脑半球、小脑、脑干和脊髓有多个环形强化病变。在诊断为中枢神经系统结核瘤后，患者开始接受常规抗结核治疗，预后良好。
