Journal Article

Tuberculous Radiculomyelitis Complicating Tuberculous Meningitis: Case Report and Review

Susana Hernández-Albújar, Jose R. Arribas, Arantxa Royo, Juan J. González-García, Jose M. Peña and Juan J. Vázquez

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 6, pages 915-921
Published in print June 2000 | ISSN: 1058-4838
Published online June 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313821
Tuberculous Radiculomyelitis Complicating Tuberculous Meningitis: Case Report and Review

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Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM that developed in an human immunodeficiency virus (HIV)—infected patient, despite prompt antituberculous treatment. To our knowledge, this is the second case of TBRM reported in an HIV-infected patient. We also review 74 previously reported cases of TBRM. TBRM develops at various periods after TBM, even in adequately treated patients after sterilization of the cerebrospinal fluid (CSF). The most common symptoms are subacute paraparesis, radicular pain, bladder disturbance, and subsequent paralysis. CSF evaluation usually shows an active inflammatory response with a very high protein level. MRI and CT scan are critical for diagnosis, revealing loculation and obliteration of the subarachnoid space along with linear intradural enhancement. As in other forms of paradoxical reactions to antituberculous treatment, there is evidence that steroid treatment might have a beneficial effect.

Journal Article.  3222 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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