Swai Hedwiga F, Moledina Sibtain M, Nsato Sylvia B, Mgunya Amina, Rugemalila Joan, Byemelwa Veridiana, Ismail Sharon, Chale Pauline, Mwapule Luth, Masao Alex, Tarimo Jude, Meda Amunga, Muhali Fatuma, Shoo May, Uiso Eva, Rwezaura Stella, Minja Eliaichi, Beda Deogratius, Nyagabona Sarah K, Kisanga Onesmo, Salehe Sayan, Chiwanga Faraja, Mwemba Said, Rwegasha John, Shayo Grace
Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
SAGE Open Med Case Rep. 2024 Aug 19;12:2050313X241274223. doi: 10.1177/2050313X241274223. eCollection 2024.
A middle-aged woman presents with chronic foot arthritis which progressed to a non-healing ulcer, which was unresponsive to conventional antibiotics and debridement. She then developed cerebral manifestations and was empirically treated with antitubercular medications which led to healing of the ulcer. Unfortunately, delays in initiating treatment resulted in development of other extrapulmonary tuberculosis complications such as cerebral tuberculoma with tuberculous meningitis. She was subsequently diagnosed with neurocysticercosis which continued to worsen during her hospital stay. She eventually succumbed to her illness due to the complications and a possible nosocomial infection. This case highlights the challenges with diagnosis of uncommon presentations of common diseases in an endemic area, leading to diagnostic delays and development of serious complications.
一名中年女性患有慢性足部关节炎，病情发展为不愈合溃疡，对常规抗生素和清创治疗无反应。随后她出现脑部症状，接受抗结核药物经验性治疗后溃疡愈合。不幸的是，治疗开始延迟导致出现其他肺外结核并发症，如脑结核瘤伴结核性脑膜炎。她随后被诊断为神经囊尾蚴病，在住院期间病情持续恶化。最终，由于并发症和可能的医院感染，她因病去世。该病例凸显了在地方病流行地区诊断常见疾病罕见表现所面临的挑战，导致诊断延迟和严重并发症的发生。
