Occurrence of multidrug-resistant tuberculous meningitis associated with injury during spinal surgery: A case report

作者：Mingwei Zhao, Ling Liu, Miao Wang, Weidong Zhou, Minglei Zhang, Han Xiao, Yu Pang · 发表于：Journal of Infection and Public Health · 年份：2020 · DOI：10.1016/j.jiph.2020.05.022 · 被引用次数：2 · 研究领域：Infectious Diseases and Tuberculosis、Orthopedic Infections and Treatments、Head and Neck Surgical Oncology

Here we describe a case of multidrug-resistant tuberculous meningitis associated with injury inflicted during spinal surgery. A 54-year-old man was diagnosed with multidrug-resistant spinal tuberculosis (TB). Anterior debridement and fusion with posterior fusion and instrumentation were conducted to remove damaged bone and TB-associated granulomatous tissue. After surgical decompression, a lancet wound (about 5mm in length) was discovered in the cerebral dura mater at the L3 position of the vertebral body. At four weeks post-surgery, the patient experienced fever, hemiparesis, and aphasia. Cerebrospinal fluid (CSF) findings were consistent with TB meningitis, while in vitro susceptibility test results confirmed that the patient had multidrug-resistant TB. Our data highlight a possible TBM infection associated with a surgical lesion in a spinal TB patient. Rapid molecular diagnostics are urgently needed to formulate efficacious regimens for treating these patients.