PMC9475202_01
MRI of the brain and cervical vertebra of our case. The axial section T1 weighted image showing hydrocephalus (arrow) (A). The sagittal section T1 weighted image showing hydrocephalus (arrow) (B). The axial section T2 weighted image shows hydrocephalus (arrow) (C). The sagittal section T2 weighted image showing hydrocephalus (arrow) (D).
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F1
Enhanced MRI of the brain and cervicothoracic region revealed abnormal enhanced meningeal pia and subarachnoid spaces with signs of communicating hydrocephalus (Figures 1, 2).
MRI of the brain and thoracic vertebra of our case. The sagittal section enhanced the image of the brain showing marked nodular enhancement under the pia mater (arrow) (A). The axial section and sagittal section of the thoracic vertebra showing marked nodular enhancement in the spinal cord (arrow) (B). The sagittal section of the thoracic vertebra showing marked nodular enhancement in the spinal cord (arrow) (C).
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F2
Enhanced MRI of the brain and cervicothoracic region revealed abnormal enhanced meningeal pia and subarachnoid spaces with signs of communicating hydrocephalus (Figures 1, 2).
MRI of the brain and lumbar vertebra of our case. The sagittal section and axial section of the lumbar vertebra showing marked nodular enhancement in the spinal cord at the level of the second lumbar vertebra (arrow) (A). The axial section of the lumbar vertebra showing marked nodular enhancement in the spinal cord at the same level in picture (A) (arrow) (B).
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F3
Enhanced MRI of the lumbar spine (performed on 17 February 2022) revealed nodules and irregularly thickened meninges (Figure 3).
Clinical course, CSF findings, and antibiotic regimens for our case.
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F4
However, empirical treatment with anti-tuberculous drugs, antibiotics, antiviral drugs, and drugs to reduce the intracranial pressure (Figure 4), did not improve his condition. Despite empirical treatments with anti-tuberculous drugs (isoniazid, linezolid, moxifloxacin, and tigecycline) which are the same treatment in the previous hospital due to insufficient course (Figure 4), the patient's condition worsened (decreasing myodynamia of limbs and endorsed racing thoughts) and he was transferred to our hospital. According to the Chinese NTM guidelines, amikacin, tigecycline, clarithromycin, and imipenem were administered (Figure 4).