Tuberculosis (Tb) Longitudinal Extensive Transverse Myelitis: A Rare and Challenging Diagnosis

Central nervous system tuberculosis, accounting for about 1% of all tuberculosis cases, manifests as transverse myelitis, involving one or more vertebral segments of the spinal cord. In rare instances, it can extend to involve three or more segments, which would be classied as longitudinally extensive transverse myelitis(LETM). The causes of LETM can be attributed to various factors, including, infections, neoplasms, vascular, and autoimmune and demyelinating diseases. Interestingly, mycobacterium tuberculosis is a rare cause of LETM. In this report, we present a case of a 43-year-old male who was presented with acute progressive quadriparesis with bladder and bowel involvement diagnosed as LETM secondary to TB. This case underscores the importance of considering tuberculosis as a differential diagnosis of LETM, particularly in endemic regions.