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Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report

BACKGROUND: Tuberculous myelitis is a rare manifestation of tuberculosis (TB) that is usually caused by hematogenous spread of Mycobacterium tuberculosis (MTB). Neurosyphilis is a neurological disease that occurs when Treponema pallidum invades the brain or the spinal cord. Individually, these two d...

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Autores principales: Gu, Lu-Yan, Tian, Jun, Yan, Ya-Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610852/
https://www.ncbi.nlm.nih.gov/pubmed/34877302
http://dx.doi.org/10.12998/wjcc.v9.i31.9645
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author Gu, Lu-Yan
Tian, Jun
Yan, Ya-Ping
author_facet Gu, Lu-Yan
Tian, Jun
Yan, Ya-Ping
author_sort Gu, Lu-Yan
collection PubMed
description BACKGROUND: Tuberculous myelitis is a rare manifestation of tuberculosis (TB) that is usually caused by hematogenous spread of Mycobacterium tuberculosis (MTB). Neurosyphilis is a neurological disease that occurs when Treponema pallidum invades the brain or the spinal cord. Individually, these two diseases involving the spinal cord are rare and cases of concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis have seldom been reported. CASE SUMMARY: A 56-year-old man presented with numbness and pain of both lower limbs for 2 wk and dysuria for 1 wk. Syphilis serology and cerebrospinal fluid (CSF) analysis supported the diagnosis of neurosyphilis and the patient was treated with intravenous ceftriaxone at first, but symptoms still progressed. Then, magnetic resonance images revealed multiple lesions along the cervicothoracic junction, and chest computed tomography showed a typical TB lesion. MTB DNA was detected in the CSF sample by metagenomic next-generation sequencing. Eventually the patient was diagnosed with tuberculous myelitis combined with asymptomatic neurosyphilis. Subsequently, quadruple anti-TB drug standardized therapy was empirically used and his neurological symptoms improved gradually. CONCLUSION: Patients can have coinfection with tuberculous transverse myelitis and asymptomatic neurosyphilis. Patients with neurosyphilis should be examined for other pathogens.
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spelling pubmed-86108522021-12-06 Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report Gu, Lu-Yan Tian, Jun Yan, Ya-Ping World J Clin Cases Case Report BACKGROUND: Tuberculous myelitis is a rare manifestation of tuberculosis (TB) that is usually caused by hematogenous spread of Mycobacterium tuberculosis (MTB). Neurosyphilis is a neurological disease that occurs when Treponema pallidum invades the brain or the spinal cord. Individually, these two diseases involving the spinal cord are rare and cases of concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis have seldom been reported. CASE SUMMARY: A 56-year-old man presented with numbness and pain of both lower limbs for 2 wk and dysuria for 1 wk. Syphilis serology and cerebrospinal fluid (CSF) analysis supported the diagnosis of neurosyphilis and the patient was treated with intravenous ceftriaxone at first, but symptoms still progressed. Then, magnetic resonance images revealed multiple lesions along the cervicothoracic junction, and chest computed tomography showed a typical TB lesion. MTB DNA was detected in the CSF sample by metagenomic next-generation sequencing. Eventually the patient was diagnosed with tuberculous myelitis combined with asymptomatic neurosyphilis. Subsequently, quadruple anti-TB drug standardized therapy was empirically used and his neurological symptoms improved gradually. CONCLUSION: Patients can have coinfection with tuberculous transverse myelitis and asymptomatic neurosyphilis. Patients with neurosyphilis should be examined for other pathogens. Baishideng Publishing Group Inc 2021-11-06 2021-11-06 /pmc/articles/PMC8610852/ /pubmed/34877302 http://dx.doi.org/10.12998/wjcc.v9.i31.9645 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Gu, Lu-Yan
Tian, Jun
Yan, Ya-Ping
Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title_full Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title_fullStr Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title_full_unstemmed Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title_short Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
title_sort concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610852/
https://www.ncbi.nlm.nih.gov/pubmed/34877302
http://dx.doi.org/10.12998/wjcc.v9.i31.9645
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