Tuberculous meningitis
Diagnosis almost certain
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Presentation of acute hydrocephalus. Combination and a combination of osseous, leptomeningeal and subependymal enhancing lesions.
Given the rapidity of change, appearances favour an infective process such as TBtuberculosis (TB), rather than metastases, lymhpomalymphoma or sarcoidosis.
This patient's CSF initial gram stain and culture were negative. However, the presumed T7/T8 discitis/osteomyelitis was biopsied under CT guidance. Although the gram stain form this biopsy was negative and there were no acid-fast bacilli identified; the subsequent PCR test and extended culture were positive for TB.
-<p>Presentation of acute hydrocephalus. Combination of osseous, leptomeningeal and subependymal enhancing lesions.</p><p>Given the rapidity of change, appearances favour an infective process such as TB, rather than metastases, lymhpoma or sarcoidosis.</p><p>This patient's CSF initial gram stain and culture were negative. However the presumed T7/T8 discitis/osteomyelitis was biopsied under CT guidance. Although the gram stain form this biopsy was negative and there were no acid-fast bacilli identified; the subsequent PCR test and extended culture were positive for TB.</p>- +<p>Presentation of acute hydrocephalus and a combination of osseous, leptomeningeal and subependymal enhancing lesions.</p><p>Given the rapidity of change, appearances favour an infective process such as tuberculosis (TB), rather than metastases, lymphoma or sarcoidosis.</p><p>This patient's CSF initial gram stain and culture were negative. However, the presumed T7/T8 discitis/osteomyelitis was biopsied under CT guidance. Although the gram stain form this biopsy was negative and there were no acid-fast bacilli identified; the subsequent PCR test and extended culture were positive for TB.</p>
Systems changed:
- Spine
- Musculoskeletal
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