{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:19:45Z","timestamp":1792873185979,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spinal tuberculosis (TB), though accounting for up to 50% of skeletal TB cases, typically presents insidiously with back pain, kyphotic deformity, or neurological deficits. Atypical presentations, including initial neutrophilic pleocytosis in cerebrospinal fluid (CSF), can mimic bacterial meningitis and complicate diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      We report the case of a 46\u2010year\u2010old previously healthy male who initially presented with high\u2010grade fever, headache, neck stiffness, and neutrophilic CSF pleocytosis suggestive of bacterial meningitis. Despite empirical antibiotic therapy, the patient developed progressive neurological symptoms, including paraplegia and hypertonia. MRI of the spine revealed T2\u2013T6 vertebral body involvement with compressive myelopathy consistent with spinal TB. CSF PCR for\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      was positive. Anti\u2010TB therapy and adjunct corticosteroids were initiated, leading to marked clinical improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinicians should maintain a high index of suspicion for spinal TB in patients with persistent fever, neurological symptoms, and CSF pleocytosis\u2014especially in TB\u2010endemic regions\u2014even when initial laboratory findings suggest bacterial meningitis. Early imaging and targeted therapy can significantly improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carm\/4815700","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T07:42:06Z","timestamp":1770622926000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An Unusual Presentation of Spinal Tuberculosis Masquerading as Pyogenic Meningitis: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7029-7781","authenticated-orcid":false,"given":"Parackrama","family":"Karunathilake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-8813","authenticated-orcid":false,"given":"Sanjeewa","family":"Bowatte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6895-7165","authenticated-orcid":false,"given":"Prabhashini","family":"Kumarihamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3978-4722","authenticated-orcid":false,"given":"Dushantha","family":"Madegedara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madushika","family":"Gunathilake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4320-9958","authenticated-orcid":false,"given":"Beruni","family":"Narmada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.2006\/002154-0"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.05.002"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2009.11.009"},{"key":"e_1_2_14_4_2","unstructured":"Global Tuberculosis Report 2024 https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2024."},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.4172\/2165-7939.1000358"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1179\/2045772311y.0000000023"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2335-7"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semss.2015.07.006"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1507511"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2005.032862"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2007.6.3.222"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/425368"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365540903428158"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03250-x"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.152835"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/23247096251329684"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.7698"},{"key":"e_1_2_14_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1384-6"},{"key":"e_1_2_14_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fradi.2025.1577840"},{"key":"e_1_2_14_20_2","unstructured":"Companion Handbook to the WHO Guidelines for the Programmatic Management of drug-resistant Tuberculosis https:\/\/www.who.int\/publications\/i\/item\/9789241548809."},{"key":"e_1_2_14_21_2","first-page":"288","article-title":"Evaluation of Streptomycin Therapy in a Controlled Series of Ninety Cases of Skeletal Tuberculosis; a Public Health Service Cooperative Investigation","volume":"34","author":"Compere E. L.","year":"1952","journal-title":"Journal of Bone Joint Surgery American"}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/4815700","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carm\/4815700","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/4815700","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:38:11Z","timestamp":1773002291000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carm\/4815700"}},"subtitle":[],"editor":[{"given":"Takanobu","family":"Hirosawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/carm\/4815700"],"URL":"https:\/\/doi.org\/10.1155\/carm\/4815700","archive":["Portico"],"relation":{},"ISSN":["1687-9627","1687-9635"],"issn-type":[{"value":"1687-9627","type":"print"},{"value":"1687-9635","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4815700"}}