AI Article Synopsis
- - A 31-year-old man was diagnosed with tuberculous meningitis (TM) that resembled CNS sarcoidosis, despite not finding Mycobacterium tuberculosis (MTB) in his cerebrospinal fluid (CSF).
- - An elevated level of adenosine deaminase (ADA) in the CSF and a brain biopsy revealing caseous granuloma led to the TM diagnosis, highlighting that brain biopsies should be considered when MTB is undetectable.
- - The patient responded well to a combination of antituberculosis drugs and corticosteroid therapy, although the steroids needed to be carefully tapered down.
Article Abstract
We report a 31-year-old man with tuberculous meningitis (TM) mimicking CNS sarcoidosis. Although Mycobacterium tuberculosis (MTB) was not detected in CSF, the level of adenosine deaminase (ADA) in CSF was significantly raised. Brain biopsy showed caseous granuloma and a diagnosis of TM was made. The diagnosis of TM is often difficult and brain biopsy should be considered if MTB is not detected in the CSF. Evaluation of CSF ADA level could also strongly contribute to distinguishing TM from other meningitis. In addition to antituberculosis drugs, corticosteroid therapy was effective in our patient but careful reduction of its dosage was required.
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| http://dx.doi.org/10.2169/internalmedicine.46.0349 | DOI Listing |
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