Case Reports
Tuberculous meningitis complicated with thoracic cord myelitis; a diagnostic conundrum
Authors:
D. W. A. Shantha ,
Teaching Hospital, Peradeniya, LK
D. Yasaratne,
Teaching Hospital, Peradeniya, LK
About D.
Department of Medicine, Faculty of Medicine, University of Peradeniya
D. M. P. U. K. Ralapanawa,
Teaching Hospital, Peradeniya, LK
About D. M. P. U. K.
Department of Medicine, Faculty of Medicine, University of Peradeniya
T. Jayalath,
Teaching Hospital, Peradeniya, LK
About T.
Department of Medicine, Faculty of Medicine, University of Peradeniya
S. Abeyagunawardena,
Teaching Hospital, Peradeniya, LK
About S.
Department of Medicine, Faculty of Medicine, University of Peradeniya
D. M. P. K. Dissanayake,
Teaching Hospital, Peradeniya, LK
W. J. B. S. M. S. Jayawardana
Teaching Hospital, Peradeniya, LK
Abstract
Tuberculosis is known as the great masquerader for its ability to present atypically. We report a case of a young man presented with progressive tuberculous meningitis and subsequently developed paraplegia due to thoracic cord myelitis, where diagnosis was confirmed bacteriologically. We highlight the presence of acute gastric dilatation as a warning sign of thoracic cord involvement and the place for CSF examination and spinal imaging in arriving at a clinical diagnosis, as treatment needs to start without delay to avoid permanent sequelae. Patient showed a good response to a combined approach of anti-tuberculosis treatment, systemic steroids and intravenous immunoglobulin.
How to Cite:
Shantha, D.W.A., Yasaratne, D., Ralapanawa, D.M.P.U.K., Jayalath, T., Abeyagunawardena, S., Dissanayake, D.M.P.K. and Jayawardana, W.J.B.S.M.S., 2021. Tuberculous meningitis complicated with thoracic cord myelitis; a diagnostic conundrum. Sri Lanka Journal of Medicine, 30(1), pp.132–137. DOI: http://doi.org/10.4038/sljm.v30i1.264
Published on
01 Jul 2021.
Peer Reviewed
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