Ningyuan Wen1, Fumin Zhao2,3, Yu Zhu3,4, Fenglin Jia2,3, Chaomin Wan3,4, Yang Wen5,6. 1. College of Clinical Medicine, Sichuan University, Chengdu, China. 2. Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China. 3. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. 4. Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section of Renmin South Road, 610041, Chengdu, China. 5. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. xiaozhijuan@aliyun.com. 6. Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section of Renmin South Road, 610041, Chengdu, China. xiaozhijuan@aliyun.com.
Abstract
BACKGROUND: Syringomyelia secondary to tuberculous meningitis (TBM) is rarely reported, and is usually a late complication. Acute development of syringomyelia following TBM is an exceedingly rare condition with only a few cases published in adults and no previous reports in children. CASE PRESENTATION: We present a case of syringomyelia as an acute complication of TBM in a 12-year-old boy despite appropriate chemotherapy. The patient developed spastic paraplegia of the lower limbs with fecal and urinary retention seventeen days after the initial symptoms of TBM. He was managed successfully with continued chemotherapy and high-dose intravenous immunoglobulin (IVIG). CONCLUSIONS: This case reminds us that syrinx formation may be responsible for early neurological deterioration in children being managed for TBM. IVIG may be considered as an effective treatment option for this situation.
BACKGROUND:Syringomyelia secondary to tuberculous meningitis (TBM) is rarely reported, and is usually a late complication. Acute development of syringomyelia following TBM is an exceedingly rare condition with only a few cases published in adults and no previous reports in children. CASE PRESENTATION: We present a case of syringomyelia as an acute complication of TBM in a 12-year-old boy despite appropriate chemotherapy. The patient developed spastic paraplegia of the lower limbs with fecal and urinary retention seventeen days after the initial symptoms of TBM. He was managed successfully with continued chemotherapy and high-dose intravenous immunoglobulin (IVIG). CONCLUSIONS: This case reminds us that syrinx formation may be responsible for early neurological deterioration in children being managed for TBM. IVIG may be considered as an effective treatment option for this situation.
Authors: Guy E Thwaites; Duc Bang Nguyen; Huy Dung Nguyen; Thi Quy Hoang; Thi Tuong Oanh Do; Thi Cam Thoa Nguyen; Quang Hien Nguyen; Tri Thuc Nguyen; Ngoc Hai Nguyen; Thi Ngoc Lan Nguyen; Ngoc Lan Nguyen; Hong Duc Nguyen; Ngoc Tuan Vu; Huu Hiep Cao; Thi Hong Chau Tran; Phuong Mai Pham; Thi Dung Nguyen; Kasia Stepniewska; Nicholas J White; Tinh Hien Tran; Jeremy J Farrar Journal: N Engl J Med Date: 2004-10-21 Impact factor: 91.245