Gu LY, Tian J, Yan YP. Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report. World J Clin Cases 2021; 9(31): 9645-9651 [PMID: 34877302 DOI: 10.12998/wjcc.v9.i31.9645]
Corresponding Author of This Article
Ya-Ping Yan, MD, Chief Doctor, Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. yanyaping@zju.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Cases. Nov 6, 2021; 9(31): 9645-9651 Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9645
Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis: A case report
Lu-Yan Gu, Jun Tian, Ya-Ping Yan
Lu-Yan Gu, Jun Tian, Ya-Ping Yan, Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Gu LY reviewed the literature and contributed to drafting the manuscript; Tian J was responsible for the collection of the patient information and writing the clinical records; Yan YP reviewed the literature, interpreted the imaging findings, and contributed to drafting the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and accompanying images and clinical data.
Conflict-of-interest statement: There is no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Ya-Ping Yan, MD, Chief Doctor, Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. yanyaping@zju.edu.cn
Received: May 30, 2021 Peer-review started: May 30, 2021 First decision: June 24, 2021 Revised: July 7, 2021 Accepted: September 8, 2021 Article in press: September 8, 2021 Published online: November 6, 2021
Abstract
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.
Core Tip: The present case indicates that possibility of coinfection with tuberculous transverse myelitis and asymptomatic neurosyphilis. We need to identify which infection is the main cause of the disease.
