Seizures, Paraplegia, and Cough Unveiling Disseminated Tuberculosis

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Seizures, Paraplegia, and Cough Unveiling Disseminated Tuberculosis Jean-Luc Baudel, MD, Vincent Dubée, MD, PhD, Juliette Palle, MD, Hafid Ait-Oufella, MD, PhD The American Journal of Medicine Volume 129, Issue 1, Pages e5-e6 (January 2016) DOI: 10.1016/j.amjmed.2015.06.048 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure (A) Postcontrast computed tomography (CT) of the brain, showing multiple ring-enhancing lesions corresponding to tuberculous granulomas (arrows). Postcontrast magnetic resonance imaging (B) reveals similar lesions in the brainstem, the cerebellum, and the spinal cord (arrows). (C) Chest CT demonstrating a fine diffuse micronodular pattern with centrilobular predominance consistent with small airway infection as evidenced by peripheral “tree-in-bud” opacities (subpleural area enlargement in the window), as well as noncentrilobular fine nodules consistent with super-imposed miliary disease. (D) Pelvis CT gated on bones. The right sacroiliac joint demonstrates asymmetric widening with cortical destruction on both sides of the joint. There is bony destruction of the posterior medial iliac bone with a pathological fracture as evidenced by cortical breaks medially and laterally (arrow). The American Journal of Medicine 2016 129, e5-e6DOI: (10.1016/j.amjmed.2015.06.048) Copyright © 2016 Elsevier Inc. Terms and Conditions