Abstract
Background:
Tuberculosis affecting the central nervous system is well recognized, but only rarely localizes to the medullary conus.
Observation:
We report the case of a 69 year old man who was admitted to our unit with cauda equina syndrome. The MRI demonstrated ring-enhanced necrotizing lesions involving the medullary conus, the cervical cord and the brain. His chest CT scan showed a miliary infiltrate. The clinical presentation was associated with an inappropriate secretion of antidiuretic hormone. Quadruple antituberculous therapy was initiated, with corticosteroids in the initial phase of the treatment. Evolution was favorable, and follow-up MRI imaging demonstrated complete resolution of the cervical cord and brain lesions.
Copyright © 2011. Published by Elsevier Masson SAS.
MeSH terms
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Adrenal Cortex Hormones / therapeutic use
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Aged
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Antitubercular Agents / therapeutic use
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Brain / microbiology
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Cervical Vertebrae* / microbiology
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Drug Therapy, Combination
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Humans
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Inappropriate ADH Syndrome / etiology
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Lumbar Vertebrae* / microbiology
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Magnetic Resonance Imaging
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Male
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Radiography
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Remission Induction
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Spinal Cord Compression / etiology*
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Tuberculoma / complications*
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Tuberculoma / drug therapy
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Tuberculosis, Central Nervous System / complications
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Tuberculosis, Meningeal / drug therapy
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Tuberculosis, Meningeal / etiology
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Tuberculosis, Miliary / diagnostic imaging
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Tuberculosis, Miliary / drug therapy
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Tuberculosis, Pulmonary / complications
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Tuberculosis, Pulmonary / diagnostic imaging
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Tuberculosis, Spinal / complications*
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Tuberculosis, Spinal / drug therapy
Substances
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Adrenal Cortex Hormones
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Antitubercular Agents