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A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant

A seven-month-old previously healthy female infant presented with acute onset encephalopathy and left focal weakness in the setting of three months of non-productive cough. She was diagnosed with pulmonary tuberculosis (TB), and neuroimaging showed multifocal non-enhancing T2 hyperintensities in the...

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Autores principales: Yang, Jennifer H, Vuong, Kim T, Moodley, Amaran, Chuang, Nathaniel A, Chen, Dillon Y
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351760/
https://www.ncbi.nlm.nih.gov/pubmed/34381655
http://dx.doi.org/10.7759/cureus.16299
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author Yang, Jennifer H
Vuong, Kim T
Moodley, Amaran
Chuang, Nathaniel A
Chen, Dillon Y
author_facet Yang, Jennifer H
Vuong, Kim T
Moodley, Amaran
Chuang, Nathaniel A
Chen, Dillon Y
author_sort Yang, Jennifer H
collection PubMed
description A seven-month-old previously healthy female infant presented with acute onset encephalopathy and left focal weakness in the setting of three months of non-productive cough. She was diagnosed with pulmonary tuberculosis (TB), and neuroimaging showed multifocal non-enhancing T2 hyperintensities in the brain and longitudinal T2 hyperintensity in the spinal cord consistent with acute disseminated encephalomyelitis (ADEM). However, her cerebrospinal fluid (CSF) did not show evidence of TB infection. She was treated with high-dose steroids for five days with a steroid taper along with antitubercular medications with a remarkable recovery in gross motor function. This case suggests a previously unreported association between TB and an immune-mediated demyelinating syndrome in children that is clinically distinct from other more common forms of TB-associated central nervous system (CNS) complications.
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spelling pubmed-83517602021-08-10 A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant Yang, Jennifer H Vuong, Kim T Moodley, Amaran Chuang, Nathaniel A Chen, Dillon Y Cureus Neurology A seven-month-old previously healthy female infant presented with acute onset encephalopathy and left focal weakness in the setting of three months of non-productive cough. She was diagnosed with pulmonary tuberculosis (TB), and neuroimaging showed multifocal non-enhancing T2 hyperintensities in the brain and longitudinal T2 hyperintensity in the spinal cord consistent with acute disseminated encephalomyelitis (ADEM). However, her cerebrospinal fluid (CSF) did not show evidence of TB infection. She was treated with high-dose steroids for five days with a steroid taper along with antitubercular medications with a remarkable recovery in gross motor function. This case suggests a previously unreported association between TB and an immune-mediated demyelinating syndrome in children that is clinically distinct from other more common forms of TB-associated central nervous system (CNS) complications. Cureus 2021-07-10 /pmc/articles/PMC8351760/ /pubmed/34381655 http://dx.doi.org/10.7759/cureus.16299 Text en Copyright © 2021, Yang et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Yang, Jennifer H
Vuong, Kim T
Moodley, Amaran
Chuang, Nathaniel A
Chen, Dillon Y
A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title_full A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title_fullStr A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title_full_unstemmed A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title_short A Case of Tuberculosis-Associated Acute Disseminated Encephalomyelitis in a Seven-Month-Old Infant
title_sort case of tuberculosis-associated acute disseminated encephalomyelitis in a seven-month-old infant
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351760/
https://www.ncbi.nlm.nih.gov/pubmed/34381655
http://dx.doi.org/10.7759/cureus.16299
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