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Tuberculous meningitis complicated with thoracic cord myelitis; a diagnostic conundrum

Authors:

D. W. A. Shantha ,

Teaching Hospital, Peradeniya, LK
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D. Yasaratne,

Teaching Hospital, Peradeniya, LK
About D.
Department of Medicine, Faculty of Medicine, University of Peradeniya
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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
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T. Jayalath,

Teaching Hospital, Peradeniya, LK
About T.
Department of Medicine, Faculty of Medicine, University of Peradeniya
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S. Abeyagunawardena,

Teaching Hospital, Peradeniya, LK
About S.
Department of Medicine, Faculty of Medicine, University of Peradeniya
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D. M. P. K. Dissanayake,

Teaching Hospital, Peradeniya, LK
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W. J. B. S. M. S. Jayawardana

Teaching Hospital, Peradeniya, LK
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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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