CENTRAL NERVOUS SYSTEM TUBERCULOSIS- CASE REPORT CASE REPORT

Tatjana Cepreganova Cangovska, Ilija Zdravkov, Angela Aleksovska, Daniela Ristic-Stomnaroska, Elena Joveva
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Abstract

Mycobacterium tuberculosis is the leading cause of morbidity and mortality worldwide. Tuberculosis is the second most common cause of death due to an infectious agent worldwide after COVID-19 infection. Central nervous system tuberculosis (CNS-TB), accounts for approximately 1% of all cases of tuberculosis, and the most common clinical presentation is tuberculous meningitis (TBM). Tuberculosis of the central nervous system is a devastating disease that, even under appropriate antituberculin therapy, leads to high mortality rate. In this paper we present a case report of a patient in whom the disease begins slowly, progressively and chronically, with the initial clinical manifestation of dementia syndrome. Usually, TBM presents with a subacute progressive febrile illness. In 2 to 3 weeks defines meningitis phase with headache, meningismus, vomiting, mild confusion. Rare is the atypical presentation of CNS TB, as in our case. During the hospitalization, brain magnetic resonance was performed with suspicious finding for neuroinfection, Due to the suspected finding of magnetic resonance imaging, a lumbar puncture was performed and the cerebrospinal fluid was sent for analysis for specific causes, including Mycobacterium tuberculosis. Correct diagnosis and therapy in these patients are a challenge for neurologists. Key words: central nervous system tuberculosis, mycobacterium tuberculosis, neuroinfection.  
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中枢神经系统结核病例报告
结核分枝杆菌是全世界发病率和死亡率的主要原因。结核病是仅次于COVID-19感染的全球第二大传染病死亡原因。中枢神经系统结核(CNS-TB)约占所有结核病病例的1%,最常见的临床表现是结核性脑膜炎(TBM)。中枢神经系统结核病是一种毁灭性疾病,即使在适当的抗结核药物治疗下,也会导致高死亡率。在这篇论文中,我们提出了一个病例报告的病人,在他们的疾病开始缓慢,进行性和慢性,与痴呆综合征的最初临床表现。TBM通常表现为亚急性进行性发热性疾病。2至3周为脑膜炎期,伴有头痛、脑膜裂、呕吐、轻度意识不清。罕见的是中枢神经系统结核的非典型表现,如本病例。住院期间行脑磁共振检查,发现疑似神经感染,由于磁共振成像发现可疑,行腰椎穿刺,并送脑脊液分析具体原因,包括结核分枝杆菌。对这些患者的正确诊断和治疗对神经科医生来说是一个挑战。关键词:中枢神经系统结核,结核分枝杆菌,神经感染。今天早上
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