Dr Manizheh Jozpanahi, Dr Afsaneh Karami,
Volume 17, Issue 67 (8-2009)
Abstract
Meningitis is one of the serious complications of extra pulmonary tuberculosis (TB). TB meningitis is the most common chronic meningitis in the world. Early diagnosis and treatment of TB meningitis will decrease the probability of focal neurological defects in these patients. AFB smear and culture are the methods that routinely are used for the diagnosis of tuberculosis. Polymerase Chain Reaction (PCR) of CSF samples is a specific diagnostic technique to approve the TB meningitis infectious. A 26 years old woman with a 10 days history of continuous global headache, nausea and restlessness referred to a neurologist. A brain CT scan without contrast was normal. Then a lumbar puncture (LP) was carried out and CSF sample was analyzed. An aseptic meningitis pattern in the CSF test was observed. All of the other tests were showed to be normal. There was no change in the result of the secondary LP test and CSF analysis that was done less than 24 hours after the first LP. Regarding to the seasonal prevalence of entroviruses, causes of lymphocytic viral meningitis was ruled out. Tuberculin Skin Test (TST) was positive in this patient. The PCR of CSF sample for TB was positive. So the diagnosis of TB meningitis was approved and treatment was started. The patient had a good condition after one year of treatment. Since the TB infectious has a variety of presentations that could be unusual, we should think about TB in patients with similar manifestations of meningitis and pneumonia. Due to its specificity, PCR in these conditions is a very helpful method for TB diagnosis as it can detect few copies of bacilli in biological samples.
Abdoreza Ghoreishy, Manizheh Jozpanahi, Ali Niksirat,
Volume 21, Issue 87 (6-2013)
Abstract
Shingles is a delayed reactivation of varicella zoster virus as an outcome of sensory ganglia. Manifestation of sensory symptoms and vesicular dermatomal rashes in sensory area of involved nerve root is an expected event in the activation of herpes from sensory afferents whereby motor weakness and paralysis rarely occur. The present case was a 64-year old man with diabetes and immunodeficiency caused by immune-suppressant drugs. After appearance of vesicular rashes in the right leg, he had difficulty in walking due to motor weakness of the right leg.