Neuro-Sweet disease with positive modified acid-fast staining of the cerebrospinal fluid: A case report

Liu,Juan‑Fang; Li,Yuan; Li,Kai; Zhang,Xiao; Yang,Yi‑Ning; Zhao,Gang; Liu,Zhi‑Rong

doi:10.3892/etm.2016.3052

April-2016 Volume 11 Issue 4

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April-2016 Volume 11 Issue 4

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Case Report Open Access

Neuro-Sweet disease with positive modified acid-fast staining of the cerebrospinal fluid: A case report

Authors:
- Juan‑Fang Liu
- Yuan Li
- Kai Li
- Xiao Zhang
- Yi‑Ning Yang
- Gang Zhao
- Zhi‑Rong Liu
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Affiliations: Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China, Department of Clinical Medicine, Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China, Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China

Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 1239-1242
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Published online on: February 8, 2016

https://doi.org/10.3892/etm.2016.3052
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Abstract

Neuro-Sweet disease (NSD) is Sweet disease with central nervous system (CNS) involvement. To the best of our knowledge, the present case report is the first to describe NSD complicated by endogenous infection with Mycobacterium tuberculosis. The present case report describes a male patient who developed NSD-induced meningitis, which initially manifested as a fever, headache and neck stiffness. Painful erythematous plaques subsequently developed on his face, neck and upper trunk. Brain magnetic resonance imaging was performed and the results were normal, whereas modified acid‑fast stain analysis of the cerebrospinal fluid (CSF) provided a positive result. The patient was thus diagnosed with viral meningitis and tuberculosis. However, subsequent skin biopsy results demonstrated neutrophilic infiltration into the dermis without vasculitis, and subsequent human leukocyte antigen typing was positive for Cw1 and negative for B51 and the patient was diagnosed with NSD. Following treatment with corticosteroids, and antiviral and anti‑tuberculotic agents, the clinical symptoms were reduced and the previously abnormal findings in the CSF examinations and associated laboratory data were improved. The present case indicates that the diagnosis of NSD is not easily achieved, and early skin biopsy is vital to ensure a fast and effective diagnosis. In addition to systemic corticosteroids, comprehensive treatment is also recommended for patients with NSD complicated by additional complex medical problems.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Neuro-Sweet disease with positive modified acid-fast staining of the cerebrospinal fluid: A case report

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